Provider Demographics
NPI:1811180102
Name:POSEGATE, SARAH ELIZABETH (OT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:POSEGATE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 WILLOW CREEK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1404
Mailing Address - Country:US
Mailing Address - Phone:928-443-1120
Mailing Address - Fax:928-443-1123
Practice Address - Street 1:1231 WILLOW CREEK RD
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1404
Practice Address - Country:US
Practice Address - Phone:928-443-1120
Practice Address - Fax:928-443-1123
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2326225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ502395Medicaid
AZ502395Medicaid
1124187406Medicare NSC
AZZ113265Medicare PIN
1972718583Medicare NSC
1427117704Medicare NSC
1396819546Medicare NSC
AZ117636Medicare PIN