Mrs. Sara Lynn Buckwalter Bravo
Mental Health Occupational Therapist - Pediatrics
95202a Hudson Ln
Fort Drum
, New York 13603-3041
Mrs. Sara Lynn Buckwalter Bravo
Mental Health Occupational Therapist - Pediatrics
95202a Hudson Ln
Fort Drum
, New York 13603-3041
(717) 572-9813
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About
Features
Specialties
- Mental Health
- Occupational Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Mrs. Sara Lynn Buckwalter Bravo
- 95202a Hudson Ln
- Fort Drum, NY
- Zip : 13603-3041
- Phone : (717) 572-9813
Second Address
- Mrs. Sara Lynn Buckwalter Bravo
- 95202a Hudson Ln
- Fort Drum, NY
- Zip : 13603-3041
- Phone : (717) 572-9813
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 225XM0800X | Mental Health | OC010940 | PA |
| Y | 225XP0200X | Occupational Therapist - Pediatrics | 025705 | NY |
National Provider Identifier
| NPI | 1417191388 |
|---|---|
| Provider Name | Mrs. Sara Lynn Buckwalter Bravo |
| First Address | Fort Drum, NY 13603-3041 |
| Second Address | Fort Drum, NY 13603-3041 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/04/2009 |
| Last Update Date | 28/09/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.