Provider Demographics
NPI:1548609423
Name:VITALE, SARA N
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:N
Last Name:VITALE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:N
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 VALLEY CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:VT
Mailing Address - Zip Code:05143-8413
Mailing Address - Country:US
Mailing Address - Phone:802-246-7603
Mailing Address - Fax:
Practice Address - Street 1:16 TOWN CRIER DR
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-8669
Practice Address - Country:US
Practice Address - Phone:802-258-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)