Provider Demographics
NPI:1134227242
Name:VORE, SARAH B (OT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:VORE
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 1:7130 W CHRISTINE ST
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-5144
Mailing Address - Country:US
Mailing Address - Phone:512-695-7819
Mailing Address - Fax:512-306-7380
Practice Address - Street 1:411 W HAYCRAFT AVE STE D1
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8104
Practice Address - Country:US
Practice Address - Phone:208-664-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109634225XP0200X, 225X00000X
ID9671934225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX109634OtherSTATE BOARD
TX8T4309OtherBCBS