Provider Demographics
NPI:1437893724
Name:SAWYER, KARSEN
Entity Type:Individual
Prefix:
First Name:KARSEN
Middle Name:
Last Name:SAWYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10747 EDENOAKS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3225
Mailing Address - Country:US
Mailing Address - Phone:805-807-4252
Mailing Address - Fax:
Practice Address - Street 1:19901 W CATAWBA AVE STE 104
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4040
Practice Address - Country:US
Practice Address - Phone:704-610-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14796224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant