Provider Demographics
NPI:1659403913
Name:HALL, SARA (OTRL)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HIGH HOPES CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1452
Mailing Address - Country:US
Mailing Address - Phone:615-661-5437
Mailing Address - Fax:
Practice Address - Street 1:301 HIGH HOPES CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1452
Practice Address - Country:US
Practice Address - Phone:615-661-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01993225XP0200X
MO2005032605225XP0200X
TNOT0000004176225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1861675084OtherINSURANCE