Provider Demographics
NPI:1346422490
Name:COLEMAN, SARAH SUZANNE (PSYD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SUZANNE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOODSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9318
Mailing Address - Country:US
Mailing Address - Phone:316-733-4727
Mailing Address - Fax:
Practice Address - Street 1:120 S GORDY ST STE 3
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2900
Practice Address - Country:US
Practice Address - Phone:316-321-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-LP 1695103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical