Provider Demographics
NPI:1275792756
Name:CLARK, SARAH (MS CGC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CLARK
Suffix:
Gender:F
Credentials:MS CGC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HUTCHINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CGC
Mailing Address - Street 1:30 SHELBURNE ROAD
Mailing Address - Street 2:PO BOX 9317 DEPT MFM
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06904-9317
Mailing Address - Country:US
Mailing Address - Phone:203-276-7132
Mailing Address - Fax:203-276-7908
Practice Address - Street 1:30 SHELBURNE ROAD
Practice Address - Street 2:STAMFORD HOSPITAL DEPT MFM
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06904-9317
Practice Address - Country:US
Practice Address - Phone:203-276-7132
Practice Address - Fax:203-276-7908
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2002165170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS