Provider Demographics
NPI:1609343714
Name:WIGNALL, SARAH BETH (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:WIGNALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3634
Mailing Address - Country:US
Mailing Address - Phone:401-648-1946
Mailing Address - Fax:
Practice Address - Street 1:30 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02905-3634
Practice Address - Country:US
Practice Address - Phone:401-648-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT00194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMFT00194OtherMARRIAGE AND FAMILY THERAPY