Provider Demographics
NPI:1285850594
Name:GUILLET, SARAH ABBOTT (LP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ABBOTT
Last Name:GUILLET
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 KNOX AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5238
Mailing Address - Country:US
Mailing Address - Phone:612-922-8269
Mailing Address - Fax:612-922-6504
Practice Address - Street 1:4809 KNOX AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-5238
Practice Address - Country:US
Practice Address - Phone:612-922-8269
Practice Address - Fax:612-922-6504
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1777103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling