Provider Demographics
NPI:1437755675
Name:HODERLEIN, SARAH LOUISE (ATC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:HODERLEIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12184 WATERS EDGE CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-4828
Mailing Address - Country:US
Mailing Address - Phone:513-543-8773
Mailing Address - Fax:
Practice Address - Street 1:12184 WATERS EDGE CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-4828
Practice Address - Country:US
Practice Address - Phone:513-543-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer