Provider Demographics
NPI:1801829544
Name:SPREDA, SARAH LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LEE
Last Name:SPREDA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0010
Mailing Address - Country:US
Mailing Address - Phone:469-879-9588
Mailing Address - Fax:972-509-1450
Practice Address - Street 1:6136 FRISCO SQUARE BLVD
Practice Address - Street 2:STE 400
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3246
Practice Address - Country:US
Practice Address - Phone:469-879-9588
Practice Address - Fax:972-509-1450
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31831103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175163801Medicaid
TXP00279239OtherRAILROAD
TX8D6783OtherBCBS
TX613540Medicare PIN