Provider Demographics
NPI:1790180263
Name:BADER, SARAH L (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:BADER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 W 35TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2909
Mailing Address - Country:US
Mailing Address - Phone:308-237-7388
Mailing Address - Fax:308-237-7394
Practice Address - Street 1:516 W 14TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949
Practice Address - Country:US
Practice Address - Phone:308-995-2865
Practice Address - Fax:308-995-4127
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE1734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist