Provider Demographics
NPI:1104019017
Name:FINCH, SARA PATREA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:PATREA
Last Name:FINCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:PATREA
Other - Last Name:TOMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9520 PROTOTYPE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5916
Mailing Address - Country:US
Mailing Address - Phone:775-852-6323
Mailing Address - Fax:775-852-6321
Practice Address - Street 1:9520 PROTOTYPE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5916
Practice Address - Country:US
Practice Address - Phone:775-852-6323
Practice Address - Fax:775-852-6321
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0540225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100512817Medicaid
NV100512817Medicaid