Provider Demographics
NPI:1619301850
Name:KIRBY, SARA JANE (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JANE
Last Name:KIRBY
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 1:200 W 12TH ST
Mailing Address - Street 2:SUITE A1-100
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-4771
Mailing Address - Country:US
Mailing Address - Phone:540-241-5910
Mailing Address - Fax:540-941-5502
Practice Address - Street 1:200 W 12TH ST
Practice Address - Street 2:SUITE A1-100
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-4771
Practice Address - Country:US
Practice Address - Phone:540-241-5910
Practice Address - Fax:540-941-5502
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002876225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics