Provider Demographics
NPI:1699806737
Name:SCHAFER, SARAH RENEE (MOT OTRL)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RENEE
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MOT OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12397 AUDRAIN ROAD 717
Mailing Address - Street 2:
Mailing Address - City:BENTON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65232-2215
Mailing Address - Country:US
Mailing Address - Phone:573-581-4179
Mailing Address - Fax:
Practice Address - Street 1:12397 AUDRAIN ROAD 717
Practice Address - Street 2:
Practice Address - City:BENTON CITY
Practice Address - State:MO
Practice Address - Zip Code:65232-2215
Practice Address - Country:US
Practice Address - Phone:573-581-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001475225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO477588008Medicaid