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NPI Code Detail

MEDICARE: SARA MICHELLE DESROSIER

MEDICARE: SARA MICHELLE DESROSIER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOC60109877WA

General Provider Information

NPI Number : 1013240514
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA MICHELLE DESROSIER
Provider Business Mailing Address
First Line : 29318 STATE HIGHWAY 89
Second Line :
City : ROSEAU
State : MN
Zip : 56751-8322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1310 NW DEANE ST
Second Line :
City : PULLMAN
State : WA
Zip : 99163-3705
Country : US
Telephone Number : 509-332-1566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2009
Last Update Date : 09/15/2009

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Directions to “ SARA MICHELLE DESROSIER ” Practice Location

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