Provider Demographics
NPI:1851633549
Name:DANSEREAU, SARAH PATRICIA (COTA/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PATRICIA
Last Name:DANSEREAU
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 TARA LN
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3940
Mailing Address - Country:US
Mailing Address - Phone:401-309-3229
Mailing Address - Fax:
Practice Address - Street 1:184 TARA LN
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3940
Practice Address - Country:US
Practice Address - Phone:401-309-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOTA00236-G174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist