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Individual
SARA PROBASCO VIVODA
Active
Individual
SARA PROBASCO VIVODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, CLC
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
IL
225X00000X
Occupational Therapist
Primary
056.009836
IL
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
056.009836
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93-3026418
CLEMENTINEPEDIATRICS
IL
Enumeration date
08/30/2012
Last updated
10/01/2025
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