Provider Demographics
NPI:1417572751
Name:BADGER, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BADGER
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 1:2211 ARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1521
Mailing Address - Country:US
Mailing Address - Phone:937-222-9481
Mailing Address - Fax:
Practice Address - Street 1:2211 ARBOR BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1521
Practice Address - Country:US
Practice Address - Phone:937-222-9481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator