Provider Demographics
NPI:1083078190
Name:MANG, SARAH ELIZABETH (BA, CSP)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:MANG
Suffix:
Gender:F
Credentials:BA, CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PINE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4013
Mailing Address - Country:US
Mailing Address - Phone:843-422-3719
Mailing Address - Fax:
Practice Address - Street 1:70 PINE FOREST DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4013
Practice Address - Country:US
Practice Address - Phone:843-422-3719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor