Provider Demographics
NPI:1215629803
Name:ORTIZ DAVITT, SARA RENEE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:RENEE
Last Name:ORTIZ DAVITT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 LOCUST ST STE 331
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3753
Mailing Address - Country:US
Mailing Address - Phone:603-706-7109
Mailing Address - Fax:
Practice Address - Street 1:61 LOCUST ST STE 331
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3753
Practice Address - Country:US
Practice Address - Phone:603-706-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2962225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist