Provider Demographics
NPI:1710014261
Name:SANTO, SARA JANE (OTRL)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JANE
Last Name:SANTO
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 1:3121 MAYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1920
Mailing Address - Country:US
Mailing Address - Phone:502-445-0909
Mailing Address - Fax:
Practice Address - Street 1:3121 MAYWOOD PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1920
Practice Address - Country:US
Practice Address - Phone:502-445-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3060225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist