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General NPI Number Information
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NPI Number | 1780046383
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Entity Type | Individual
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Provider Name | COURTNEY SARA GILBERT MSOTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 77 BATES ST
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City | LEWISTON
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State | ME
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Zip | 04240-7637
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Country | US
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Telephone | 207-795-2122
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Fax |
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Provider Business Mailing Address
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Address Line | 2439 WILLWOOD DR
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City | FLORENCE
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State | SC
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Zip | 29501-3904
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Country | US
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Telephone | 843-777-2043
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Fax |
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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 | OT005673
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT. 4701 OT
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2715
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License Number State | ME
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