Provider Demographics
NPI:1639294911
Name:GRAHAM, SARAH (OTR)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:TINMOUTH
Mailing Address - State:VT
Mailing Address - Zip Code:05773-9319
Mailing Address - Country:US
Mailing Address - Phone:603-496-5780
Mailing Address - Fax:
Practice Address - Street 1:13 ADAMS RD
Practice Address - Street 2:SUITE 126
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-8408
Practice Address - Country:US
Practice Address - Phone:802-747-8678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072-0000589225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics