Individual
SARAH DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2801 S WEBSTER AVE, GREEN BAY, WI 54301-2878
(920) 337-1122
Mailing address
2801 S WEBSTER AVE, GREEN BAY, WI 54301-2878
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5421-27
WI
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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