Provider Demographics
NPI:1548409170
Name:DORR, SARAH JO (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JO
Last Name:DORR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JO
Other - Last Name:PRIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:580 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CARLYLE
Mailing Address - State:IL
Mailing Address - Zip Code:62231-1803
Mailing Address - Country:US
Mailing Address - Phone:618-594-4581
Mailing Address - Fax:618-594-8482
Practice Address - Street 1:580 8TH ST
Practice Address - Street 2:
Practice Address - City:CARLYLE
Practice Address - State:IL
Practice Address - Zip Code:62231-1803
Practice Address - Country:US
Practice Address - Phone:618-594-4581
Practice Address - Fax:618-594-8482
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)