Basic Information
Provider Information
NPI: 1275679466
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATTON
FirstName: SABINE
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: OCCUPATIONAL THERAPI
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 417 W 3RD AVE
Address2:  
City: ALBANY
State: GA
PostalCode: 317011943
CountryCode: US
TelephoneNumber: 2293121000
FaxNumber: 2293121221
Practice Location
Address1: 417 W 3RD AVE
Address2:  
City: ALBANY
State: GA
PostalCode: 317011943
CountryCode: US
TelephoneNumber: 2293124411
FaxNumber: 2293121221
Other Information
ProviderEnumerationDate: 01/29/2007
LastUpdateDate: 02/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT002171GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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