Provider Demographics
NPI:1033973458
Name:KNOLL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KNOLL
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 1:43 TOWN AND COUNTRY DRIVE
Mailing Address - Street 2:SUITE #119 PMB 91
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405
Mailing Address - Country:US
Mailing Address - Phone:540-846-7797
Mailing Address - Fax:
Practice Address - Street 1:43 TOWN AND COUNTRY DRIVE
Practice Address - Street 2:SUITE #119 PMB 91
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405
Practice Address - Country:US
Practice Address - Phone:540-846-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional