Provider Demographics
NPI:1598572620
Name:SYLVIA, SARAH JEAN (OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:SYLVIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18-4 ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-6903
Mailing Address - Country:US
Mailing Address - Phone:860-508-4697
Mailing Address - Fax:
Practice Address - Street 1:14 CLUB RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:CT
Practice Address - Zip Code:06280-1000
Practice Address - Country:US
Practice Address - Phone:860-456-1107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6561225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist