Provider Demographics
NPI:1164812491
Name:MOHNEY, SARAH (ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MOHNEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26402 TRESTLE CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-7713
Mailing Address - Country:US
Mailing Address - Phone:313-283-2151
Mailing Address - Fax:
Practice Address - Street 1:26402 TRESTLE CREEK AVE
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-7713
Practice Address - Country:US
Practice Address - Phone:313-283-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010012162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer