Provider Demographics
NPI:1407443955
Name:GREENEBAUM, SARAH A (OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:GREENEBAUM
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 1:20 ORCHARD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2325
Mailing Address - Country:US
Mailing Address - Phone:805-705-4759
Mailing Address - Fax:
Practice Address - Street 1:2 LODGE LN
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1629
Practice Address - Country:US
Practice Address - Phone:413-596-5362
Practice Address - Fax:413-596-5367
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2101225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist