Provider Demographics
NPI:1407045370
Name:GREEN, SARAH K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:K
Last Name:GREEN
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 1:72 MDOS/SGOMH MENTAL HEALTH ELEMENT
Mailing Address - Street 2:5700 ARNOLD ST. BLDG 5801
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:72 MDOS/SGOMH MENTAL HEALTH ELEMENT
Practice Address - Street 2:5700 ARNOLD ST. BLDG 5801
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145-8102
Practice Address - Country:US
Practice Address - Phone:405-734-4393
Practice Address - Fax:405-734-5399
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program