Provider Demographics
NPI:1285042044
Name:DEARING, SARAH I
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:DEARING
Suffix:I
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 1:401 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5900
Mailing Address - Country:US
Mailing Address - Phone:920-832-4792
Mailing Address - Fax:920-832-2185
Practice Address - Street 1:401 S ELM ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5900
Practice Address - Country:US
Practice Address - Phone:920-832-4792
Practice Address - Fax:920-832-2185
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7503-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical