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NPI Code Detail

MEDICARE: SARA BERNTH

MEDICARE: SARA BERNTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1154443315
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA BERNTH
Provider Business Mailing Address
First Line : 1524 DUFFER DR
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-8859
Country : US
Telephone Number : 219-983-1557
Fax Number : 219-983-1557
Provider Business Practice Location Address
First Line : 1120 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-3286
Country : US
Telephone Number : 219-983-9675
Fax Number : 219-983-9681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 02/08/2019

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Directions to “ SARA BERNTH ” Practice Location

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