Provider Demographics
NPI:1396172136
Name:DEMUTH, SARAH I (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:DEMUTH
Suffix:I
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 1:514 ORBY ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9646
Mailing Address - Country:US
Mailing Address - Phone:303-358-7479
Mailing Address - Fax:
Practice Address - Street 1:514 ORBY ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-9646
Practice Address - Country:US
Practice Address - Phone:303-358-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1362OtherSTATE OF COLORADO