Individual
MRS. SARA JO ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2703 WILLOW OAKS DR, FORT WAYNE, IN 46809-1844
(260) 747-6533
Mailing address
2703 WILLOW OAKS DR, FORT WAYNE, IN 46809-1844
(260) 747-6533
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001419A
IN
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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