Provider Demographics
NPI:1144594888
Name:NICHOLLS, SARAH MCNEAL (OTR, MOT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MCNEAL
Last Name:NICHOLLS
Suffix:
Gender:F
Credentials:OTR, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 EL PASEO ST APT 1314
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3224
Mailing Address - Country:US
Mailing Address - Phone:801-573-8186
Mailing Address - Fax:
Practice Address - Street 1:2900 WOODRIDGE DR STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-2506
Practice Address - Country:US
Practice Address - Phone:713-741-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113272225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist