Provider Demographics
NPI:1295931988
Name:HANCOCK, SARAH MICHELLE (OT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MICHELLE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:MICHELLE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:121 N 5TH ST. W
Mailing Address - Street 2:TO CAREER CENTER
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501
Mailing Address - Country:US
Mailing Address - Phone:307-921-9546
Mailing Address - Fax:
Practice Address - Street 1:121 N 5TH ST. W
Practice Address - Street 2:TO CAREER CENTER
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501
Practice Address - Country:US
Practice Address - Phone:307-921-9546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOT-582225X00000X
WY582225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY312675OtherBCBS
WYW20559Medicare ID - Type UnspecifiedPART B