Provider Demographics
NPI:1881763159
Name:DIRST, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DIRST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 E 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2506
Mailing Address - Country:US
Mailing Address - Phone:720-339-5336
Mailing Address - Fax:
Practice Address - Street 1:3102 S PARKER RD STE A15
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3108
Practice Address - Country:US
Practice Address - Phone:303-368-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1066810OtherLICENSE#