Provider Demographics
NPI:1134902562
Name:MCDONALD, SARA KATHERINE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:KATHERINE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1310
Mailing Address - Country:US
Mailing Address - Phone:740-632-8662
Mailing Address - Fax:
Practice Address - Street 1:152 UPPER SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-2746
Practice Address - Country:US
Practice Address - Phone:518-793-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT210002236225X00000X
NY028030225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist