Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 17-0960 | NV |
NPI | 1053824540 |
---|---|
Provider Name | Sara Ellen Dolensky |
First Address | Henderson, NV 89012-2438 |
Second Address | Henderson, NV 89052-5034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 07/11/2017 |