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NPI 1053073411

NPI 1053073411 : SARAH ELLEN SWEGAN : BELGRADE, MT

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General NPI Number Information
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    NPI Number           |    1053073411
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH ELLEN SWEGAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/12/2021
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    Last Update Date     |    10/12/2021
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Provider Practice Location Address
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    Address Line         |    6325 JACKRABBIT LN STE A 
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    City                 |    BELGRADE
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    State                |    MT
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    Zip                  |    59714-9128
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    Country              |    US
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    Telephone            |    406-388-4988
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6325 JACKRABBIT LN STE A 
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    City                 |    BELGRADE
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    State                |    MT
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    Zip                  |    59714-9128
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    OTP-OT-LIC-8593
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    License Number State |    MT
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