Individual
MRS. SARA MARIE ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 IRONWOOD CIR, SUITE 230, SOUTH BEND, IN 46635-1888
(574) 387-4049
(574) 387-4062
Mailing address
1226 STANLEY ST, MISHAWAKA, IN 46545-7126
(574) 621-8242
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
99048784A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99048784A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
09/27/2011
Last updated
09/27/2011
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