MEDICARE: MS. SARAH A. HOERAUF MS, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT-744LP	WY

General Provider Information

NPI Number	:	1750510590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH A. HOERAUF MS, OTR/L

Provider Business Mailing Address
First Line	:	1330 PRAIRIE AVE
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-4842
Country	:	US
Telephone Number	:	307-778-8997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 PRAIRIE
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009
Country	:	US
Telephone Number	:	307-778-8997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	07/14/2009

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