Sandra Jean Fark
Individual provider Active NPI Developmental Therapist · Murphysboro, IL
NPI 1487879409 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487879409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 1 Scenic View LN
Murphysboro, IL 62966-4755 - Phone
- (618) 687-2160
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
1 Scenic View LN
Murphysboro, IL 62966-4755
Mailing address
1 Scenic View LN
Murphysboro, IL 62966-4755
Other providers in Murphysboro, IL
- Steve Eberhart
- Lauren Petrice Eisele
- Cheryl Ellis
- Evan T Belfer MD SC
- Robyn Falaster
- Jill Denice Feltmeyer
- Marie Elizabeth Funk
- David Gardner
- Andrea Lynn Geis
- Regina Gibson
All providers in Murphysboro, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.