Healthcare Provider Details

I. General information

NPI: 1003726779
Provider Name (Legal Business Name): SARA RUTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E LIBERTY ST STE 200
ANN ARBOR MI
48104-2156
US

IV. Provider business mailing address

120 E LIBERTY ST STE 200
ANN ARBOR MI
48104-2156
US

V. Phone/Fax

Practice location:
  • Phone: 734-585-6966
  • Fax: 734-405-6314
Mailing address:
  • Phone: 734-585-6966
  • Fax: 734-405-6314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121139
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: