Provider Demographics
NPI:1386922425
Name:MCKINNON, SARAH MICHELLE (OTD)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:MICHELLE
Last Name:MCKINNON
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 1:785 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-4317
Mailing Address - Country:US
Mailing Address - Phone:267-664-2404
Mailing Address - Fax:
Practice Address - Street 1:785 E 6TH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-4317
Practice Address - Country:US
Practice Address - Phone:267-664-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10315225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist