Provider Demographics
NPI:1730529314
Name:ROGALS, SARA RUBIN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:RUBIN
Last Name:ROGALS
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 1:19 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6131
Mailing Address - Country:US
Mailing Address - Phone:617-480-9001
Mailing Address - Fax:
Practice Address - Street 1:19 ELM ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6131
Practice Address - Country:US
Practice Address - Phone:617-480-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist