Individual
SARAH L GAUTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5306 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 433-0721
Mailing address
1801 E PALM VALLEY BLVD APT 1626, ROUND ROCK, TX 78664-9480
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209927
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
Enumeration date
12/16/2009
Last updated
12/16/2009
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