Provider Demographics
NPI:1659409175
Name:DAVIS, SARA M (OTRL)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:M
Other - Last Name:SCHORNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:9015 W SILVER HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-8854
Mailing Address - Country:US
Mailing Address - Phone:316-308-4424
Mailing Address - Fax:
Practice Address - Street 1:9015 W SILVER HOLLOW CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-8854
Practice Address - Country:US
Practice Address - Phone:316-308-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1702272225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist