Provider Demographics
NPI:1083983472
Name:NYCZ, SARAH (OTR)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NYCZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HEINFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:191 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-1113
Mailing Address - Country:US
Mailing Address - Phone:419-957-3113
Mailing Address - Fax:
Practice Address - Street 1:121 S OPERA ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2057
Practice Address - Country:US
Practice Address - Phone:937-599-5195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6859225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist