Provider Demographics
NPI:1215227137
Name:KEEFE, SARAH (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KEEFE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LACRUE AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1062
Mailing Address - Country:US
Mailing Address - Phone:800-578-7906
Mailing Address - Fax:
Practice Address - Street 1:1080 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-5600
Practice Address - Country:US
Practice Address - Phone:619-204-8744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11183225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist