Provider Demographics
NPI:1033695556
Name:MITRANO, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MITRANO
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 1:320 ALPHA MILL LN APT 114
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3314
Mailing Address - Country:US
Mailing Address - Phone:585-734-9363
Mailing Address - Fax:
Practice Address - Street 1:6633 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3321
Practice Address - Country:US
Practice Address - Phone:704-366-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health