Provider Demographics
NPI:1154857464
Name:BOWD, SARA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOWD
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:WALDACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:3640 TALMAGE CIR STE 210
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55110-7100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3640 TALMAGE CIR STE 210
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-7100
Practice Address - Country:US
Practice Address - Phone:952-431-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist