Provider Demographics
NPI:1730407958
Name:WILBERT, SARA BETH (OTR)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:WILBERT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-2338
Mailing Address - Country:US
Mailing Address - Phone:732-580-0719
Mailing Address - Fax:
Practice Address - Street 1:2 HOLLYWOOD BLVD N STE 8
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-4842
Practice Address - Country:US
Practice Address - Phone:609-200-1118
Practice Address - Fax:866-368-4449
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
NJ46TR00260000225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty