Provider Demographics
NPI:1083003495
Name:FAITH, SABRINA (BC-DMT)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:FAITH
Suffix:
Gender:F
Credentials:BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HADDONFIELD BERLIN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GIBBSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08026-1228
Mailing Address - Country:US
Mailing Address - Phone:856-346-0005
Mailing Address - Fax:856-784-1799
Practice Address - Street 1:250 HADDONFIELD BERLIN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1228
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:856-784-1799
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABC-DMT-1062225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist