Provider Demographics
NPI:1790251536
Name:KOENIGHAIN, SARAH M (MOT OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:KOENIGHAIN
Suffix:
Gender:F
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 BRENTWOOD DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-1545
Mailing Address - Country:US
Mailing Address - Phone:319-720-2086
Mailing Address - Fax:
Practice Address - Street 1:1209 E 3RD ST, ANAMOSA
Practice Address - Street 2:
Practice Address - City:ANAMOSA
Practice Address - State:IA
Practice Address - Zip Code:52205
Practice Address - Country:US
Practice Address - Phone:319-462-4356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA093337225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist