Provider Demographics
NPI:1609308667
Name:MINTZ, SARAH U (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:U
Last Name:MINTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5247 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2012
Mailing Address - Country:US
Mailing Address - Phone:202-686-7699
Mailing Address - Fax:202-362-9633
Practice Address - Street 1:5247 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2012
Practice Address - Country:US
Practice Address - Phone:202-686-7699
Practice Address - Fax:202-362-9633
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1000800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical