Provider Demographics
NPI:1407393291
Name:BURDEN, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BURDEN
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 1:2528 MOUNTAIN RD
Mailing Address - Street 2:STE. 202
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7203
Mailing Address - Country:US
Mailing Address - Phone:410-456-7404
Mailing Address - Fax:410-360-1675
Practice Address - Street 1:2528 MOUNTAIN RD
Practice Address - Street 2:STE. 202
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-7203
Practice Address - Country:US
Practice Address - Phone:410-456-7404
Practice Address - Fax:410-360-1675
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health