Provider Demographics
NPI:1942612627
Name:COOPER, SARAH ANN (MS,OTR/L)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ANN
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 EDWARDS DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6032
Mailing Address - Country:US
Mailing Address - Phone:307-259-6425
Mailing Address - Fax:
Practice Address - Street 1:1935 EDWARDS DR UNIT C
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6032
Practice Address - Country:US
Practice Address - Phone:307-259-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY805225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics