Provider Demographics
NPI:1194550749
Name:KOOKEN, SARA SIEMENS (OTD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:SIEMENS
Last Name:KOOKEN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 QUINN HILL LN
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754-0705
Mailing Address - Country:US
Mailing Address - Phone:919-923-8273
Mailing Address - Fax:
Practice Address - Street 1:1007 BAKERS CREEK RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-8441
Practice Address - Country:US
Practice Address - Phone:828-208-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14657225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist