Provider Demographics
NPI: | 1861172801 |
---|---|
Name: | DIDOMENICO, SARAH (MS, OTR/L, WCC, CHT) |
Entity type: | Individual |
Prefix: | |
First Name: | SARAH |
Middle Name: | |
Last Name: | DIDOMENICO |
Suffix: | |
Gender: | F |
Credentials: | MS, OTR/L, WCC, CHT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 6841 FOREST HILL AVE UNIT 408 |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHMOND |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23225-1603 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-424-5480 |
Mailing Address - Fax: | 804-424-4114 |
Practice Address - Street 1: | 6841 FOREST HILL AVE UNIT 408 |
Practice Address - Street 2: | |
Practice Address - City: | RICHMOND |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23225-1603 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-424-5480 |
Practice Address - Fax: | 804-424-4114 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2023-07-24 |
Last Update Date: | 2025-09-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0119005912 | 225XN1300X, 225X00000X, 225XH1300X, 225XE1200X, 225XP0019X, 225XP0200X, 225XH1200X, 225XE0001X, 225XG0600X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225XH1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | |
No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors | |
No | 225XE1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Ergonomics | |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | |
No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification | |
No | 225XG0600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |