Provider Demographics
NPI:1992902340
Name:GORMAN, SARAH K (OT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:K
Last Name:GORMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:121 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:PA
Mailing Address - Zip Code:18810-1601
Mailing Address - Country:US
Mailing Address - Phone:607-972-4210
Mailing Address - Fax:607-687-1209
Practice Address - Street 1:211 MAIN ST
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1633
Practice Address - Country:US
Practice Address - Phone:607-948-4047
Practice Address - Fax:607-687-1209
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013415-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist