Provider Demographics
NPI:1902201452
Name:LUSK, SARA K (OTR/L)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:LUSK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5541 W 102ND PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-4103
Mailing Address - Country:US
Mailing Address - Phone:303-656-6453
Mailing Address - Fax:303-404-3042
Practice Address - Street 1:5541 W 102ND PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-4103
Practice Address - Country:US
Practice Address - Phone:303-656-6453
Practice Address - Fax:303-404-3042
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1312225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics