Provider Demographics
NPI:1538815493
Name:JOSLIN, SARA JO
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:JOSLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 TAMMY ST
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4392
Mailing Address - Country:US
Mailing Address - Phone:850-272-6372
Mailing Address - Fax:
Practice Address - Street 1:2641 HADDASSAH DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-3067
Practice Address - Country:US
Practice Address - Phone:850-257-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL605174H00000X
FL3181225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No174H00000XOther Service ProvidersHealth Educator