Provider Demographics
NPI:1922768936
Name:SIMPLOT, SARAH ANNE (BCTMB, LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:SIMPLOT
Suffix:
Gender:F
Credentials:BCTMB, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PENN PL APT H
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3317
Mailing Address - Country:US
Mailing Address - Phone:917-232-2543
Mailing Address - Fax:
Practice Address - Street 1:2 PENN PL APT H
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3317
Practice Address - Country:US
Practice Address - Phone:917-232-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10651225A00000X
CT010651225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist