Provider Demographics
NPI:1578019865
Name:ROOP, SARAH ANN (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:ROOP
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16590 S. LONE SAGUARO RD
Mailing Address - Street 2:HC 70 BOX 3700
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629
Mailing Address - Country:US
Mailing Address - Phone:520-304-1629
Mailing Address - Fax:
Practice Address - Street 1:3920 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1917
Practice Address - Country:US
Practice Address - Phone:520-471-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3471171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor