Provider Demographics
NPI:1346998580
Name:GEORGE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GEORGE
Suffix:
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:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:IN
Mailing Address - Zip Code:46182-0093
Mailing Address - Country:US
Mailing Address - Phone:317-796-4224
Mailing Address - Fax:
Practice Address - Street 1:503 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:IN
Practice Address - Zip Code:46182-0110
Practice Address - Country:US
Practice Address - Phone:317-796-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician