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General NPI Number Information
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NPI Number | 1154626224
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Entity Type | Individual
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Provider Name | SHARON DIANE SANDERSON O.T.
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Gender | Female
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 249 E. UMPHRESS
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City | VAN ALSTYNE
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State | TX
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Zip | 75495-0758
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Country | US
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Telephone | 903-482-6822
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Fax |
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Provider Business Mailing Address
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Address Line | 249 E. UMPHRESS P.O. BOX 758
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City | VAN ALSTYNE
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State | TX
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Zip | 75495-0758
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Country | US
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Telephone | 903-482-6822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 107302
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License Number State | TX
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