Basic Information
| Provider Information | |||||||||
| NPI: | 1801176870 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEKIMOTO | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | JUANITA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2070 IVY STREET NORTH | ||||||||
| Address2: | |||||||||
| City: | NORTH ST. PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513383228 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4415 WEST 36 1/2 STREET | ||||||||
| Address2: | |||||||||
| City: | ST. LOUIS PARK | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529279717 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2011 | ||||||||
| LastUpdateDate: | 08/23/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 103975 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.