Provider Demographics
NPI:1396931903
Name:CHERCHIAN, SARAH L (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:L
Last Name:CHERCHIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:WETTERNECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 N STOUGHTON RD # 2433
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2605
Mailing Address - Country:US
Mailing Address - Phone:608-838-8999
Mailing Address - Fax:
Practice Address - Street 1:317 KNUTSON DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1133
Practice Address - Country:US
Practice Address - Phone:608-535-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3269225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3269OtherOCCUPATIONAL THERAPIST