Provider Demographics
NPI:1407867732
Name:MUIR, SARAH A (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:MUIR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16341
Mailing Address - Country:US
Mailing Address - Phone:814-589-1843
Mailing Address - Fax:
Practice Address - Street 1:224 S MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346
Practice Address - Country:US
Practice Address - Phone:814-677-1390
Practice Address - Fax:814-677-1393
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006769L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019430850002Medicaid