Provider Demographics
NPI:1043607617
Name:KENDZIORSKI, SARAH (MS/OTRL)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:KENDZIORSKI
Suffix:
Gender:F
Credentials:MS/OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 122ND AVE
Mailing Address - Street 2:PO DRAWER 130
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9511
Mailing Address - Country:US
Mailing Address - Phone:269-673-5854
Mailing Address - Fax:
Practice Address - Street 1:3283 122ND AVE
Practice Address - Street 2:PO DRAWER 130
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9511
Practice Address - Country:US
Practice Address - Phone:269-673-5854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005123225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist