Provider Demographics
NPI:1174005706
Name:SAYRE, SARA NICOLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:NICOLE
Last Name:SAYRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 HILLS AND DALES RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1663
Mailing Address - Country:US
Mailing Address - Phone:330-492-2006
Mailing Address - Fax:330-492-2161
Practice Address - Street 1:4319 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1663
Practice Address - Country:US
Practice Address - Phone:330-492-2006
Practice Address - Fax:330-492-2161
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07773103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling