Provider Demographics
NPI:1851505168
Name:STOLL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STOLL
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 1:4542 E INVERNESS AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4619
Mailing Address - Country:US
Mailing Address - Phone:480-926-6309
Mailing Address - Fax:480-926-1365
Practice Address - Street 1:4542 E INVERNESS AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4619
Practice Address - Country:US
Practice Address - Phone:480-926-6309
Practice Address - Fax:480-926-1365
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3868225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics