Provider Demographics
NPI:1093293409
Name:HAMILTON, SARAH JAYNE (OTR IL)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JAYNE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OTR IL
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:JAYNE
Other - Last Name:COCANOUGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR IL
Mailing Address - Street 1:4121 SHELBYVILLE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3205
Mailing Address - Country:US
Mailing Address - Phone:502-893-1380
Mailing Address - Fax:502-893-1773
Practice Address - Street 1:4121 SHELBYVILLE RD STE 7
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-893-1380
Practice Address - Fax:502-893-1773
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY241347225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1346687332OtherNPI