Provider Demographics
NPI:1164864088
Name:HARE, SARAH MARIE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 MILLERS STATION RD
Mailing Address - Street 2:PO BOX 97
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-2035
Mailing Address - Country:US
Mailing Address - Phone:443-375-1372
Mailing Address - Fax:
Practice Address - Street 1:552 S PASEO DOROTEA STE 4
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1437
Practice Address - Country:US
Practice Address - Phone:760-325-5950
Practice Address - Fax:760-325-5945
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40359225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist