Provider Demographics
NPI:1609057504
Name:AINSWORTH, SARAH ANN (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:AINSWORTH
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 1:19 HODSKIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1175
Mailing Address - Country:US
Mailing Address - Phone:315-393-0992
Mailing Address - Fax:315-393-0993
Practice Address - Street 1:531 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4084
Practice Address - Country:US
Practice Address - Phone:315-212-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014847-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist