Provider Demographics
NPI:1316266455
Name:WOOLEVER, SARAH KATHLEEN (MT-BC, NMT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KATHLEEN
Last Name:WOOLEVER
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 XERXES AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-2851
Mailing Address - Country:US
Mailing Address - Phone:763-521-3477
Mailing Address - Fax:
Practice Address - Street 1:1501 XERXES AVE N
Practice Address - Street 2:2438 18TH. AVENUE SOUTH
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-2851
Practice Address - Country:US
Practice Address - Phone:763-521-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN06583225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist