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General NPI Number Information
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NPI Number | 1619301850
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Entity Type | Individual
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Provider Name | SARA JANE KIRBY MS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 200 W 12TH ST SUITE A1-100
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City | WAYNESBORO
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State | VA
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Zip | 22980-4771
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Country | US
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Telephone | 540-241-5910
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Fax | 540-941-5502
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Provider Business Mailing Address
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Address Line | 200 W 12TH ST SUITE A1-100
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City | WAYNESBORO
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State | VA
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Zip | 22980-4771
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Country | US
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Telephone | 540-241-5910
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Fax | 540-941-5502
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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 | 0119002876
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License Number State | VA
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