Provider Demographics
NPI:1699212746
Name:SAWYER-SMITH, SADIE (OT)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:SAWYER-SMITH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:689 S APOLLO BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1455
Mailing Address - Country:US
Mailing Address - Phone:321-674-5035
Mailing Address - Fax:
Practice Address - Street 1:689 S APOLLO BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1455
Practice Address - Country:US
Practice Address - Phone:321-674-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist