Provider Demographics
NPI:1639234834
Name:EVANS, SARAH J (OTRL)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:J
Last Name:EVANS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:712 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-1307
Mailing Address - Country:US
Mailing Address - Phone:479-521-4001
Mailing Address - Fax:479-521-1621
Practice Address - Street 1:3419 N PLAINVIEW AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4065
Practice Address - Country:US
Practice Address - Phone:479-521-4001
Practice Address - Fax:479-521-1621
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1680225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist