Provider Demographics
NPI:1205326998
Name:BAXTER, SARA ELIZABETH (CERTIFIED OCCUPATION)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELIZABETH
Last Name:BAXTER
Suffix:
Gender:F
Credentials:CERTIFIED OCCUPATION
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:LIPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502
Mailing Address - Country:US
Mailing Address - Phone:859-629-6106
Mailing Address - Fax:859-422-6712
Practice Address - Street 1:710 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502
Practice Address - Country:US
Practice Address - Phone:859-629-6106
Practice Address - Fax:859-422-6712
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA5001224ZR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility