Provider Demographics
NPI:1649908815
Name:AGHA, SABRINA AISHA (OTR/L)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:AISHA
Last Name:AGHA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 BRIELLA DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3767
Mailing Address - Country:US
Mailing Address - Phone:561-699-9059
Mailing Address - Fax:
Practice Address - Street 1:5970 S JOG RD STE A-1
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6590
Practice Address - Country:US
Practice Address - Phone:561-300-1999
Practice Address - Fax:561-300-1990
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist