Basic Information
Provider Information
NPI: 1235482373
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAUSER
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MA OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22 COLEMAN PL APT 18
Address2:  
City: MENLO PARK
State: CA
PostalCode: 940252487
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1580 SAWGRASS CORPORATE PKWY
Address2: SUITE 100
City: SUNRISE
State: FL
PostalCode: 333232859
CountryCode: US
TelephoneNumber: 9547394247
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/25/2012
LastUpdateDate: 10/25/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X12552CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home