Provider Demographics
NPI:1548747918
Name:ADDICKS, SARAH HAYES (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:HAYES
Last Name:ADDICKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:280 SMITH AVE N STE 220
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2459
Mailing Address - Country:US
Mailing Address - Phone:651-241-8295
Mailing Address - Fax:651-241-7300
Practice Address - Street 1:280 SMITH AVE N STE 220
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2459
Practice Address - Country:US
Practice Address - Phone:651-241-8295
Practice Address - Fax:651-241-7300
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP6477103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical