Provider Demographics
NPI:1437867074
Name:RAGER, SARAH ANN (MT-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:RAGER
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 1:5115 N SOCRUM LOOP RD APT 357
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-8201
Mailing Address - Country:US
Mailing Address - Phone:863-797-7159
Mailing Address - Fax:877-369-2965
Practice Address - Street 1:3726 CLEVELAND HEIGHTS BLVD APT 20
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-0202
Practice Address - Country:US
Practice Address - Phone:863-797-7159
Practice Address - Fax:877-369-2965
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16726225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist