Provider Demographics
NPI:1063785913
Name:WEINER, SARAH (OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WEINER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1931
Mailing Address - Country:US
Mailing Address - Phone:602-714-6024
Mailing Address - Fax:
Practice Address - Street 1:5601 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2903
Practice Address - Country:US
Practice Address - Phone:602-664-7927
Practice Address - Fax:602-664-7999
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4853225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics