Provider Demographics
NPI:1497111231
Name:TRUNCER, SARAH KAITLYN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KAITLYN
Last Name:TRUNCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KAITLYN
Other - Last Name:DORSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1229 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3527
Mailing Address - Country:US
Mailing Address - Phone:850-215-6770
Mailing Address - Fax:850-665-0123
Practice Address - Street 1:1229 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3527
Practice Address - Country:US
Practice Address - Phone:850-215-6770
Practice Address - Fax:850-665-0123
Is Sole Proprietor?:No
Enumeration Date:2016-01-09
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst