Provider Demographics
NPI:1639503873
Name:GUINN, SARA RAE (MMED, MT-BC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:RAE
Last Name:GUINN
Suffix:
Gender:F
Credentials:MMED, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 MARIETTA HWY
Mailing Address - Street 2:SUITE 630-132
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6755
Mailing Address - Country:US
Mailing Address - Phone:404-277-1998
Mailing Address - Fax:
Practice Address - Street 1:880 MARIETTA HWY
Practice Address - Street 2:SUITE 630-132
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-6755
Practice Address - Country:US
Practice Address - Phone:404-277-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09853225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist