Provider Demographics
NPI:1609286939
Name:MARTIN, SARAH (MED, BSL)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MED, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-2630
Mailing Address - Country:US
Mailing Address - Phone:610-704-6544
Mailing Address - Fax:
Practice Address - Street 1:938 E ELM ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-2630
Practice Address - Country:US
Practice Address - Phone:610-704-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001853103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst