Provider Demographics
NPI:1487088324
Name:TERRILL, SARAH JANE (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:JANE
Last Name:TERRILL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CARLETON ST
Mailing Address - Street 2:APT. # 2
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3345
Mailing Address - Country:US
Mailing Address - Phone:207-446-4664
Mailing Address - Fax:
Practice Address - Street 1:117 STROUDWATER ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4045
Practice Address - Country:US
Practice Address - Phone:207-854-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA1643224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant