Provider Demographics
NPI:1053885574
Name:NELSON, SARAH CATHERINE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 25TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1248
Mailing Address - Country:US
Mailing Address - Phone:828-781-7467
Mailing Address - Fax:
Practice Address - Street 1:803 7TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2117
Practice Address - Country:US
Practice Address - Phone:304-523-1164
Practice Address - Fax:304-522-2474
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12711225X00000X
WV2010225X00000X
MN106749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN106749OtherMN STATE OT LICENSE