Provider Demographics
NPI:1417619735
Name:WESBECHER, SARAH ROSE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:WESBECHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-2068
Mailing Address - Country:US
Mailing Address - Phone:573-330-1367
Mailing Address - Fax:
Practice Address - Street 1:501 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601-2068
Practice Address - Country:US
Practice Address - Phone:573-330-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician