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General NPI Number Information
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NPI Number | 1790172476
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Entity Type | Individual
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Provider Name | SARAH KOPPENHOEFER-LITTLE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 2650 E MCDOWELL RD # 200
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City | PHOENIX
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State | AZ
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Zip | 85008-3658
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Country | US
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Telephone | 623-242-6908
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Fax |
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Provider Business Mailing Address
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Address Line | 14535 W INDIAN SCHOOL RD STE 100
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City | GOODYEAR
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State | AZ
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Zip | 85395-9282
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Country | US
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Telephone |
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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 | 6125
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License Number State | AZ
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