Provider Demographics
NPI:1851308001
Name:COATS, SARAH MILLER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MILLER
Last Name:COATS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:KATHERYN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2623 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1713
Mailing Address - Country:US
Mailing Address - Phone:580-297-9960
Mailing Address - Fax:580-297-9996
Practice Address - Street 1:2623 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1713
Practice Address - Country:US
Practice Address - Phone:580-297-9960
Practice Address - Fax:580-297-9996
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1024103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200421850AMedicaid