Provider Demographics
NPI:1457730624
Name:DAHLE, SARAH KRISTY
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTY
Last Name:DAHLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KRISTY
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:742 STERBENZ DR
Mailing Address - Street 2:ST CROIX THERAPY INC
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8327
Mailing Address - Country:US
Mailing Address - Phone:715-386-2128
Mailing Address - Fax:715-386-6119
Practice Address - Street 1:742 STERBENZ DR
Practice Address - Street 2:ST CROIX THERAPY INC
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8327
Practice Address - Country:US
Practice Address - Phone:715-386-2128
Practice Address - Fax:715-386-6119
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2317OtherWISCONSIN LICENSE