Provider Demographics
NPI:1326658907
Name:MILLER, SARAH (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 S CROSBY ST
Mailing Address - Street 2:
Mailing Address - City:EAGAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85925-9876
Mailing Address - Country:US
Mailing Address - Phone:623-385-6977
Mailing Address - Fax:
Practice Address - Street 1:682 W SCHOOL BUS LN
Practice Address - Street 2:
Practice Address - City:SNOWFLAKE
Practice Address - State:AZ
Practice Address - Zip Code:85937-5262
Practice Address - Country:US
Practice Address - Phone:928-536-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008187225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist