Provider Demographics
NPI:1568693448
Name:WEBSTER, SALLY M (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:M
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 INDEPENDENCE AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1255
Mailing Address - Country:US
Mailing Address - Phone:251-406-1274
Mailing Address - Fax:
Practice Address - Street 1:658 INDEPENDENCE AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1255
Practice Address - Country:US
Practice Address - Phone:251-406-1274
Practice Address - Fax:251-406-1274
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2648225XP0200X
DCOT010000829225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics