Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1764-26 | WI |
NPI | 1205105509 |
---|---|
Provider Name | Ms. Sarah Louise Calvert |
First Address | Greenfield, WI 53220-2814 |
Second Address | Greenfield, WI 53220-2814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2011 |
Last Update Date | 04/04/2014 |