Healthcare Provider Details

I. General information

NPI: 1114196433
Provider Name (Legal Business Name): MRS. SARAH CHRISTINE SAETTELE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 W A ST
BELLEVILLE IL
62223-2408
US

IV. Provider business mailing address

PO BOX 23078
BELLEVILLE IL
62223-0078
US

V. Phone/Fax

Practice location:
  • Phone: 618-398-4311
  • Fax: 618-355-4415
Mailing address:
  • Phone: 618-398-4311
  • Fax: 618-355-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: