Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1706 | OK |
N | 225X00000X | Occupational Therapist | OTR1616 | AR |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OTR1616 | AR |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OTR1616 | AR |
NPI | 1063051399 |
---|---|
Provider Name | Sarah Beth Rader |
First Address | Charleston, AR 72933-9557 |
Second Address | Sallisaw, OK 74955-2672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2020 |
Last Update Date | 03/01/2020 |