Provider Demographics
NPI:1326709643
Name:WYGLE, SARAH MICHELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:WYGLE
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 1:103 TALON DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8601
Mailing Address - Country:US
Mailing Address - Phone:919-610-7734
Mailing Address - Fax:
Practice Address - Street 1:12448 SW 127TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6596
Practice Address - Country:US
Practice Address - Phone:305-255-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22013225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist