Individual
SARA M CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3431 N 13TH ST, SHEBOYGAN, WI 53083-2938
(920) 457-5046
Mailing address
W860 KIEL RD, NEW HOLSTEIN, WI 53061-9412
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1987-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41044800
—
WI
Enumeration date
05/17/2007
Last updated
07/08/2007
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