Provider Demographics
NPI:1487953501
Name:GUETHLE, SARAH E (OT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:GUETHLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SOUTH STATE ROUTE 53
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:MO
Mailing Address - Zip Code:63933
Mailing Address - Country:US
Mailing Address - Phone:573-246-2133
Mailing Address - Fax:573-246-3212
Practice Address - Street 1:801 SOUTH STATE ROUTE 53
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:MO
Practice Address - Zip Code:63933
Practice Address - Country:US
Practice Address - Phone:573-246-2133
Practice Address - Fax:573-246-3212
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006013430225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist