Provider Demographics
NPI:1558841932
Name:BISHOP, SARAH M
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:BISHOP
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 1:422 MAIN ST APT 59
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2341
Mailing Address - Country:US
Mailing Address - Phone:484-975-2205
Mailing Address - Fax:
Practice Address - Street 1:422 MAIN ST APT 59
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2341
Practice Address - Country:US
Practice Address - Phone:484-975-2205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA$$$$$$$$$Medicaid