Provider Demographics
NPI:1326472036
Name:PROWAK, SARAH A (MS, OTR)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:A
Last Name:PROWAK
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:PORCELAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2680 18TH ST
Mailing Address - Street 2:SUITE 150A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3994
Mailing Address - Country:US
Mailing Address - Phone:303-433-0852
Mailing Address - Fax:
Practice Address - Street 1:2680 18TH ST
Practice Address - Street 2:SUITE 150A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3994
Practice Address - Country:US
Practice Address - Phone:303-433-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003726225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics