Provider Demographics
NPI:1306566898
Name:FRIESTH, SARAH M (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:FRIESTH
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 1:8527 UNIVERSITY BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1069
Mailing Address - Country:US
Mailing Address - Phone:515-782-1436
Mailing Address - Fax:
Practice Address - Street 1:8527 UNIVERSITY BLVD STE 9
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1069
Practice Address - Country:US
Practice Address - Phone:515-782-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA121384225X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program