Provider Demographics
NPI:1487783429
Name:STRAND, SARAH ELLEN (BS/ /IECE / MED)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELLEN
Last Name:STRAND
Suffix:
Gender:F
Credentials:BS/ /IECE / MED
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELLEN
Other - Last Name:STRAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:661 ASHLEY CAMP RD
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-8711
Mailing Address - Country:US
Mailing Address - Phone:502-905-8699
Mailing Address - Fax:859-554-4086
Practice Address - Street 1:661 ASHLEY CAMP RD
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-8711
Practice Address - Country:US
Practice Address - Phone:502-905-8699
Practice Address - Fax:859-554-4086
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200217416222Q00000X
KY222Q00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1487783429Medicaid
KY562601718Medicaid