Provider Demographics
NPI:1669801502
Name:PICKLE, SARAH (OTR)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:PICKLE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 SALVIA ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2781
Mailing Address - Country:US
Mailing Address - Phone:505-412-3748
Mailing Address - Fax:
Practice Address - Street 1:12127 W COOPER DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4861
Practice Address - Country:US
Practice Address - Phone:303-437-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003845225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist