Provider Demographics
NPI:1073792198
Name:WRIGHT, SARA MARIE (MA)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:25 SHELDON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4209
Mailing Address - Country:US
Mailing Address - Phone:616-459-7062
Mailing Address - Fax:616-459-0392
Practice Address - Street 1:25 SHELDON BLVD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4209
Practice Address - Country:US
Practice Address - Phone:616-459-7062
Practice Address - Fax:616-459-0392
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health