Provider Demographics
NPI:1720574320
Name:SASAKI, DARA CATHERINE (CGC)
Entity Type:Individual
Prefix:MRS
First Name:DARA
Middle Name:CATHERINE
Last Name:SASAKI
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:MS
Other - First Name:DARA
Other - Middle Name:CATHERINE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CGC
Mailing Address - Street 1:202 FAN BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 SOUTH PENN SQUARE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-873-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDGEN-350170300000X
KYGC362170300000X
GA508170300000X
OH70.000665170300000X
FLGC395170300000X
ALGC198170300000X
OKLGC0482170300000X
ARLGC0251170300000X
TN478170300000X
LA329474170300000X
UT12543942-3601170300000X
IL246.000698170300000X
CAGC001005170300000X
PAGC000767170300000X
MAGC704170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS