Provider Demographics
NPI:1740536788
Name:WILKIRSON, SARA (MT-BC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WILKIRSON
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 1:4750 WESLEY AVE STE J
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2276
Mailing Address - Country:US
Mailing Address - Phone:513-531-5110
Mailing Address - Fax:513-531-5668
Practice Address - Street 1:4750 WESLEY AVE STE J
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2276
Practice Address - Country:US
Practice Address - Phone:513-531-5110
Practice Address - Fax:513-531-5668
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist