Provider Demographics
NPI:1003596131
Name:VANHOUDT, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VANHOUDT
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 1:1220 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1500
Mailing Address - Country:US
Mailing Address - Phone:507-532-3008
Mailing Address - Fax:507-532-3058
Practice Address - Street 1:1220 BIRCH ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1500
Practice Address - Country:US
Practice Address - Phone:507-532-3008
Practice Address - Fax:507-532-3058
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305160101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)