Provider Demographics
NPI:1649535097
Name:BOLLINGER, SARAH (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 HALIFAX DR # SR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2123
Mailing Address - Country:US
Mailing Address - Phone:352-875-2003
Mailing Address - Fax:
Practice Address - Street 1:2713 BREEZEWOOD AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5534
Practice Address - Country:US
Practice Address - Phone:910-488-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3472225X00000X
FL12242225X00000X
NC10159225XP0200X
OR213709225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist