Provider Demographics
NPI:1316582869
Name:CUCCIA, SARAH (CLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CUCCIA
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 LINDALE MANOR CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8930
Mailing Address - Country:US
Mailing Address - Phone:832-499-5003
Mailing Address - Fax:
Practice Address - Street 1:6619 LINDALE MANOR CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8930
Practice Address - Country:US
Practice Address - Phone:832-499-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN