Healthcare Provider Details

I. General information

NPI: 1326432865
Provider Name (Legal Business Name): SARAH E PESCH MSOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10539 PROFESSIONAL CIR STE 201
RENO NV
89521-3858
US

IV. Provider business mailing address

5310 KIETZKE LN STE 104
RENO NV
89511-2043
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-8800
  • Fax: 833-687-1419
Mailing address:
  • Phone: 775-348-8800
  • Fax: 833-687-1419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number557226
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number557226
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number17-0982
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: