Provider Demographics
NPI:1730649088
Name:SADLER, LOIS
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:SADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15684
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0684
Mailing Address - Country:US
Mailing Address - Phone:812-319-1135
Mailing Address - Fax:
Practice Address - Street 1:851 ERIE AVE APT E
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4189
Practice Address - Country:US
Practice Address - Phone:812-319-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000221A225X00000X
OHOT010405225X00000X
IL056001308225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist