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General NPI Number Information
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NPI Number | 1205502028
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Entity Type | Individual
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Provider Name | SARA ANDERSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 110 7TH ST W
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City | PARK RAPIDS
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State | MN
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Zip | 56470-1872
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Country | US
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Telephone | 218-669-3121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone | 605-328-6585
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Fax | 605-312-9802
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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 | 106371
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License Number State | MN
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