Provider Demographics
NPI:1629328216
Name:NIILEKSELA, SARAH (MT-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NIILEKSELA
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 1:1824 HAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5304
Mailing Address - Country:US
Mailing Address - Phone:785-424-0706
Mailing Address - Fax:
Practice Address - Street 1:1824 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-5304
Practice Address - Country:US
Practice Address - Phone:785-424-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist