Provider Demographics
NPI:1356027718
Name:IPSEN, SAVANNAH LEIGH (OTR/L)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:IPSEN
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 1:13001 W WOODSPRING ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1348
Mailing Address - Country:US
Mailing Address - Phone:208-850-3238
Mailing Address - Fax:
Practice Address - Street 1:350 IRIS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3514
Practice Address - Country:US
Practice Address - Phone:831-449-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist