Individual
MRS. SARA POLETTI STABENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
60 E VERNON AVE, PHOENIX, AZ 85004-1337
(602) 380-3377
Mailing address
PO BOX 25104, PHOENIX, AZ 85002-5104
(602) 380-3377
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056013449
IL
225X00000X
Occupational Therapist
2020000630
MO
225X00000X
Occupational Therapist
Primary
OTH008096
AZ
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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