Individual
SARA TERESA POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, DSC
Contact information
Practice address
650 JOEL DR, OCCUPATIONAL THERAPY DEPARTMENT, FORT CAMPBELL, KY 42223-5318
(719) 602-9441
Mailing address
950 BIG SKY DR, APT E-304, CLARKSVILLE, TN 37040-5273
(719) 602-9441
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004542
GA
Other
Enumeration date
12/31/2008
Last updated
02/01/2012
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