Provider Demographics
NPI:1417425521
Name:FOLSOM, SARAH (MT-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-3024
Mailing Address - Country:US
Mailing Address - Phone:860-836-5565
Mailing Address - Fax:
Practice Address - Street 1:4 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-3024
Practice Address - Country:US
Practice Address - Phone:860-836-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13161225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist