Provider Demographics
NPI:1821259052
Name:BURDEN, SARAH D (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:D
Last Name:BURDEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 THOR RD
Mailing Address - Street 2:
Mailing Address - City:WHITEMAN AFB
Mailing Address - State:MO
Mailing Address - Zip Code:65305-1105
Mailing Address - Country:US
Mailing Address - Phone:660-233-8172
Mailing Address - Fax:
Practice Address - Street 1:200 THOR RD
Practice Address - Street 2:
Practice Address - City:WHITEMAN AFB
Practice Address - State:MO
Practice Address - Zip Code:65305-1105
Practice Address - Country:US
Practice Address - Phone:660-233-8172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002000045225X00000X
MO2013030167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist