Provider Demographics
NPI:1124257183
Name:PACKARD, SARAH ANN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:PACKARD
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-3224
Mailing Address - Country:US
Mailing Address - Phone:785-737-3710
Mailing Address - Fax:
Practice Address - Street 1:813 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-3224
Practice Address - Country:US
Practice Address - Phone:785-737-3710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS02436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist