Provider Demographics
NPI:1841681129
Name:FURLETTE-KOSKI, SARA ALISON (MA ATC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ALISON
Last Name:FURLETTE-KOSKI
Suffix:
Gender:F
Credentials:MA ATC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ALISON
Other - Last Name:KOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA ATC
Mailing Address - Street 1:851 MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4776
Mailing Address - Country:US
Mailing Address - Phone:269-352-1814
Mailing Address - Fax:
Practice Address - Street 1:851 MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4776
Practice Address - Country:US
Practice Address - Phone:269-352-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0035972255A2300X
MI68011180811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801118081Medicaid