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Individual

SARA ANDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
13203 GLOBE DR STE 111, MT PLEASANT, WI 53177-1616
(262) 287-0090
Mailing address
1621 E SAVELAND AVE, MILWAUKEE, WI 53207-4022
(414) 477-6263

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XP0200X
Pediatric Occupational Therapist
6436-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043781594
WI
Enumeration date
12/10/2018
Last updated
11/16/2020
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