Basic Information
Provider Information
NPI: 1285876730
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARON
FirstName: SARA
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 32
Address2:  
City: ANDOVER
State: NH
PostalCode: 032160032
CountryCode: US
TelephoneNumber: 8009374245
FaxNumber: 8775216764
Practice Location
Address1: 91 MAPLE AVE
Address2:  
City: KEENE
State: NH
PostalCode: 034311629
CountryCode: US
TelephoneNumber: 6033583384
FaxNumber: 6033583385
Other Information
ProviderEnumerationDate: 03/30/2009
LastUpdateDate: 09/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X1423NHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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