Provider Demographics
NPI:1659594323
Name:ROHDE, SARA ELIZABETH (OTR)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH
Last Name:ROHDE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3111 124TH AVE NW
Mailing Address - Street 2:SUITE 123
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-1793
Mailing Address - Country:US
Mailing Address - Phone:763-236-8924
Mailing Address - Fax:763-236-8966
Practice Address - Street 1:3111 124TH AVE NW
Practice Address - Street 2:SUITE 123
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-1793
Practice Address - Country:US
Practice Address - Phone:763-236-8924
Practice Address - Fax:763-236-8966
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101004225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics