Provider Demographics
NPI:1821423039
Name:BURRAGE, SABRINA SEANTE' (CRT)
Entity Type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:SEANTE'
Last Name:BURRAGE
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MS
Mailing Address - Zip Code:39365-3002
Mailing Address - Country:US
Mailing Address - Phone:601-503-3651
Mailing Address - Fax:
Practice Address - Street 1:335 NORTH ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-3002
Practice Address - Country:US
Practice Address - Phone:601-503-3651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSRCP2407227800000X
OHRCP10167227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified