Provider Demographics
NPI:1558768796
Name:ALSTON, SARAH (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ALSTON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:COUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:600 LONGS PEAK AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-4015
Mailing Address - Country:US
Mailing Address - Phone:217-493-0219
Mailing Address - Fax:
Practice Address - Street 1:600 LONGS PEAK AVE APT 208
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4015
Practice Address - Country:US
Practice Address - Phone:217-493-0219
Practice Address - Fax:720-204-7403
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010001044225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist