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NPI 1316178817

NPI 1316178817 : BEVERLY J. SADLER OTR/L : GLASTONBURY, CT

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General NPI Number Information
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    NPI Number           |    1316178817
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    Entity Type          |    Individual 
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    Provider Name        |    BEVERLY J. SADLER OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/31/2009
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    Last Update Date     |    11/02/2010
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Provider Practice Location Address
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    Address Line         |    76 EASTERN BLVD SUITE 101
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    City                 |    GLASTONBURY
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    State                |    CT
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    Zip                  |    06033-4382
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    Country              |    US
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    Telephone            |    860-633-1016
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    Fax                  |    860-875-6423
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Provider Business Mailing Address
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    Address Line         |    84 SNIPSIC LAKE RD 
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    City                 |    ELLINGTON
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    State                |    CT
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    Zip                  |    06029-3519
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    Country              |    US
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    Telephone            |    860-633-1016
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    Fax                  |    860-875-6423
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    002334
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    License Number State |    CT
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