Individual
MRS. SARA LYNN BUCKWALTER BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
95202A HUDSON LN, FORT DRUM, NY 13603-3041
(717) 572-9813
Mailing address
95202A HUDSON LN, FORT DRUM, NY 13603-3041
(717) 572-9813
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
OC010940
PA
225XP0200X
Pediatric Occupational Therapist
Primary
025705
NY
Other
Enumeration date
04/23/2009
Last updated
09/28/2021
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