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General NPI Number Information
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NPI Number | 1588130371
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH ODHAM CHT, MS,OTR/L,
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Gender | Female
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1940 TAMIAMI TRL STE 104
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2105
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Country | US
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Telephone | 941-883-0083
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 TAMIAMI TRL STE 104
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2105
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Country | US
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Telephone | 941-883-0083
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Fax | 717-635-3227
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT25019
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License Number State | FL
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