Basic Information
| Provider Information | |||||||||
| NPI: | 1376905042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | SARA | ||||||||
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| Credential: | MS OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 328 RUSSELL ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537045313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088436736 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9401 OLD SAUK RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535624409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082038102 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT.0003961 | CO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 6141-26 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.