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General NPI Number Information
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NPI Number | 1184812794
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Entity Type | Individual
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Provider Name | SARAH M STAKER OTR
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 882 S FORT HOOD ST SUITE 1050
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City | KILLEEN
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State | TX
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Zip | 76541-7433
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Country | US
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Telephone | 254-554-8100
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Fax | 254-554-8142
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Provider Business Mailing Address
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Address Line | PO BOX 10340
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City | KILLEEN
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State | TX
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Zip | 76547-0340
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Country | US
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Telephone | 254-554-8100
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Fax | 254-554-8142
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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 | 112255
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License Number State | TX
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