Provider Demographics
NPI:1629649884
Name:SHARPE-WEDLUND, SARAH KAY (COTA/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KAY
Last Name:SHARPE-WEDLUND
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KAY
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2495 MAPLEWOOD DR N STE 312
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1985
Mailing Address - Country:US
Mailing Address - Phone:651-760-3109
Mailing Address - Fax:651-967-9417
Practice Address - Street 1:2495 MAPLEWOOD DR N STE 312
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1985
Practice Address - Country:US
Practice Address - Phone:651-760-3109
Practice Address - Fax:651-967-9417
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN202070224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant