Provider Demographics
NPI:1184395121
Name:SLOAN, SARA F (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:F
Last Name:SLOAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 GARMISH ST
Mailing Address - Street 2:
Mailing Address - City:ELLENBURG DEPOT
Mailing Address - State:NY
Mailing Address - Zip Code:12935-3437
Mailing Address - Country:US
Mailing Address - Phone:315-355-1751
Mailing Address - Fax:
Practice Address - Street 1:45 6TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1247
Practice Address - Country:US
Practice Address - Phone:518-481-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020803225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist