Provider Demographics
NPI:1588178644
Name:TEITELBAUM, SARAH ALLISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALLISON
Last Name:TEITELBAUM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 WEST ST STE 5
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2936
Mailing Address - Country:US
Mailing Address - Phone:413-259-1654
Mailing Address - Fax:
Practice Address - Street 1:433 WEST ST STE 5
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2936
Practice Address - Country:US
Practice Address - Phone:413-259-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10727103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist