Individual
SARA S DIIESO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/CHT
Contact information
Practice address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3236
(401) 457-1580
(401) 831-0500
Mailing address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3236
(401) 457-1580
(401) 831-0500
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT00899
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26728
BLUE CROSS BLUE SHIELD
RI
Enumeration date
07/11/2006
Last updated
10/04/2011
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