Provider Demographics
NPI:1467911552
Name:HIEBSCH, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HIEBSCH
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 368
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-0368
Mailing Address - Country:US
Mailing Address - Phone:512-778-9449
Mailing Address - Fax:844-866-7258
Practice Address - Street 1:2055 COUNTY ROAD 284
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-6077
Practice Address - Country:US
Practice Address - Phone:512-778-9449
Practice Address - Fax:844-866-7258
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional