Provider Demographics
NPI:1982361283
Name:CONDER, SARAH WHITNEY (MAE)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:WHITNEY
Last Name:CONDER
Suffix:
Gender:F
Credentials:MAE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5566 STATE ROUTE 120 E
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:KY
Mailing Address - Zip Code:42409-9658
Mailing Address - Country:US
Mailing Address - Phone:270-635-6693
Mailing Address - Fax:
Practice Address - Street 1:5566 STATE ROUTE 120 E
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:KY
Practice Address - Zip Code:42409-9658
Practice Address - Country:US
Practice Address - Phone:270-635-6693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist