Healthcare Provider Details

I. General information

NPI: 1023883246
Provider Name (Legal Business Name): MARY GRACE SANSAIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 POLARIS PKWY STE 160
WESTERVILLE OH
43082-7989
US

IV. Provider business mailing address

300 POLARIS PKWY STE 160
WESTERVILLE OH
43082-7989
US

V. Phone/Fax

Practice location:
  • Phone: 614-776-0970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: