Provider Demographics
NPI:1235458613
Name:GORDON, SARAH RHOADS (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:RHOADS
Last Name:GORDON
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 1:1945 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1300
Mailing Address - Country:US
Mailing Address - Phone:740-349-9777
Mailing Address - Fax:740-349-0787
Practice Address - Street 1:1945 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1300
Practice Address - Country:US
Practice Address - Phone:740-349-9777
Practice Address - Fax:740-349-0787
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000535225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist