Provider Demographics
NPI:1336320597
Name:URBAN, SARAH ANNE (EDS)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNE
Last Name:URBAN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 S 51ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339
Mailing Address - Country:US
Mailing Address - Phone:602-237-9100
Mailing Address - Fax:602-237-9135
Practice Address - Street 1:9401 S 51ST AVE
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2710
Practice Address - Country:US
Practice Address - Phone:602-237-9100
Practice Address - Fax:602-237-9135
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool