Provider Demographics
NPI:1376882910
Name:MUCKLER, SARA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MUCKLER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 PLAZA WAY # 410
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4325
Mailing Address - Country:US
Mailing Address - Phone:206-605-6329
Mailing Address - Fax:
Practice Address - Street 1:212 N 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1436
Practice Address - Country:US
Practice Address - Phone:208-946-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health