Provider Demographics
NPI:1861778870
Name:MEARIDA, SABRINA NICOLE (LPT)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:NICOLE
Last Name:MEARIDA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MS
Other - First Name:SABRINA
Other - Middle Name:NICOLE
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:135 N WILLIAMSBURG DR
Mailing Address - Street 2:PO BOX 5387
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-3528
Mailing Address - Country:US
Mailing Address - Phone:309-661-8823
Mailing Address - Fax:309-661-8801
Practice Address - Street 1:3918 LENOX AVE STE 430
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2667
Practice Address - Country:US
Practice Address - Phone:434-951-6355
Practice Address - Fax:434-200-8859
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018765225100000X
NCP21879225100000X
VA2305216891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist