Provider Demographics
NPI:1164274882
Name:EDMISTON, SARAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:EDMISTON
Suffix:
Gender:X
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E LOGAN AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6933
Mailing Address - Country:US
Mailing Address - Phone:814-330-7770
Mailing Address - Fax:
Practice Address - Street 1:2345 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2352
Practice Address - Country:US
Practice Address - Phone:814-330-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor