Provider Demographics
NPI:1225749781
Name:HUMPHREY, SARAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 GIESLER RD APT 22
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3641
Mailing Address - Country:US
Mailing Address - Phone:610-463-5232
Mailing Address - Fax:
Practice Address - Street 1:1694 TROY RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-8216
Practice Address - Country:US
Practice Address - Phone:812-610-2395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007936A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist