Provider Demographics
NPI:1881927572
Name:COELHO, SARAH ELLEN (ATC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELLEN
Last Name:COELHO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 DUMFRIES RD
Mailing Address - Street 2:
Mailing Address - City:CATLETT
Mailing Address - State:VA
Mailing Address - Zip Code:20119-1708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4910 DUMFRIES RD
Practice Address - Street 2:
Practice Address - City:CATLETT
Practice Address - State:VA
Practice Address - Zip Code:20119-1708
Practice Address - Country:US
Practice Address - Phone:170-358-1471
Practice Address - Fax:123-456-7891
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-12
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA20000022982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer