Individual
MS. SARA JAN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
409 BENEDICTA AVE, TRINIDAD, CO 81082-2004
(719) 846-9291
Mailing address
PO BOX 842, 29718 COUNTY ROAD #16.0, TRINIDAD, CO 81082-0842
(719) 859-0814
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
002176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA307868
NBCOT (NATIONAL BOARD OF CERTIFIED OCCUPATIONAL THERAPISTS)
—
Enumeration date
04/25/2011
Last updated
04/25/2011
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