MEDICARE: SARA PRATT

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1194063982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA PRATT

Provider Business Mailing Address
First Line	:	10683 S SAGINAW ST
Second Line	:	SUITE C
City	:	GRAND BLANC
State	:	MI
Zip	:	48439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10683 S SAGINAW ST
Second Line	:	SUITE C
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-8127
Country	:	US
Telephone Number	:	810-602-9336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2013
Last Update Date	:	01/29/2013

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Directions to “ SARA PRATT ” Practice Location

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