Provider Demographics
NPI:1033711205
Name:DEVORE, SARA JOYCELYN
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JOYCELYN
Last Name:DEVORE
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 1:101. W. 5TH ST.
Mailing Address - Street 2:
Mailing Address - City:WRIGHT CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74766-5449
Mailing Address - Country:US
Mailing Address - Phone:580-981-2202
Mailing Address - Fax:
Practice Address - Street 1:101 W. 5TH ST.
Practice Address - Street 2:
Practice Address - City:WRIGHT CITY
Practice Address - State:OK
Practice Address - Zip Code:74766
Practice Address - Country:US
Practice Address - Phone:580-981-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator