Provider Demographics
NPI:1639949795
Name:GREY, SARAH EMMETT
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:EMMETT
Last Name:GREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 N WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6084
Mailing Address - Country:US
Mailing Address - Phone:618-203-2012
Mailing Address - Fax:830-632-6183
Practice Address - Street 1:1208 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6084
Practice Address - Country:US
Practice Address - Phone:618-203-2012
Practice Address - Fax:830-632-6183
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician