Provider Demographics
NPI:1790536639
Name:ROLLINGER, SARAH CAMILLE (MED)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CAMILLE
Last Name:ROLLINGER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WEICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1604 W CURRY DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1254
Mailing Address - Country:US
Mailing Address - Phone:602-748-9443
Mailing Address - Fax:
Practice Address - Street 1:3939 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3400
Practice Address - Country:US
Practice Address - Phone:480-998-1071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool