Doctor Name: | SARA HOTRUM |
NPI Number: | 1033519509 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLMSW |
License Number: | 6801097277 |
Business Practice Address: | 5805 Oakland Dr Portage, MI - 490241118 |
Business Phone Number: | 2693231954 |
Business Fax Number: | 2693234183 |
Mailing Address: | 830 E U Ave, VICKSBURG |
State: | MI |
Postal Code: | 490978413 |
Phone Number: | 2699130019 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2014 |
NPI Last Update Date: | 09/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801097277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |