Provider Demographics
NPI:1992760060
Name:MICHAUD, SARA KAY (MS, LATC)
Entity type:Individual
Prefix:MRS
First Name:SARA KAY
Middle Name:
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:MS, LATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-2121
Mailing Address - Country:US
Mailing Address - Phone:207-834-7572
Mailing Address - Fax:207-834-7825
Practice Address - Street 1:516 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-2121
Practice Address - Country:US
Practice Address - Phone:207-834-7572
Practice Address - Fax:207-834-7825
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT2222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAT222OtherSTATE LICENSE ATHLETIC TR