Provider Demographics
NPI:1619257896
Name:ZACHARY THOMPSON, SARA KATE (PSYD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:KATE
Last Name:ZACHARY THOMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:KATE
Other - Last Name:ZACHARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5046 73RD AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4350
Mailing Address - Country:US
Mailing Address - Phone:727-541-5436
Mailing Address - Fax:
Practice Address - Street 1:5046 73RD AVE N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4350
Practice Address - Country:US
Practice Address - Phone:727-541-5436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9616103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist