Provider Demographics
NPI:1881923480
Name:BOYD, SARAH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5230 WILLOW CREEK DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-445-6800
Mailing Address - Fax:479-445-6816
Practice Address - Street 1:5230 WILLOW CREEK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-445-6800
Practice Address - Fax:479-445-6816
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2252225XP0200X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR2252OtherOT LICENSE
AR180122721Medicaid