Individual
SARAH LAUREN ICKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2680 S MEBANE ST, BURLINGTON, NC 27215-5695
(336) 397-4595
Mailing address
2104 WOODLAND AVE, BURLINGTON, NC 27215-4565
(813) 454-5166
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10107
NC
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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