Provider Demographics
NPI:1528395415
Name:MCVAUGH, SARA J (OTR)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:MCVAUGH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 SAWYER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-3412
Mailing Address - Country:US
Mailing Address - Phone:970-385-3498
Mailing Address - Fax:970-259-2618
Practice Address - Street 1:281 SAWYER DR STE 200
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-3412
Practice Address - Country:US
Practice Address - Phone:970-385-3498
Practice Address - Fax:970-259-2618
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO919225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist