Basic Information
| Provider Information | |||||||||
| NPI: | 1518192509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRAKE-RICART | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ATR, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 371 E 1ST ST | ||||||||
| Address2: | |||||||||
| City: | FOND DU LAC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549354563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9209078201 | ||||||||
| FaxNumber: | 9209078209 | ||||||||
| Practice Location | |||||||||
| Address1: | 371 E 1ST ST | ||||||||
| Address2: | |||||||||
| City: | FOND DU LAC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549354563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9209073967 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2009 | ||||||||
| LastUpdateDate: | 04/05/2018 | ||||||||
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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 | 101YP2500X | 6804-125 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 221700000X | 107-36 | WI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist |
No ID Information.