Provider Demographics
NPI:1851349583
Name:PAGE, SARAH LOUISA (PHD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISA
Last Name:PAGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RAUSH
Other - Middle Name:LOUISA
Other - Last Name:RAUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:81 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1529
Mailing Address - Country:US
Mailing Address - Phone:845-876-8349
Mailing Address - Fax:845-487-6834
Practice Address - Street 1:81 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1529
Practice Address - Country:US
Practice Address - Phone:845-876-8349
Practice Address - Fax:845-487-6834
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012319-1103TC0700X
CT001973103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012319OtherPSYCHOLOGIST LICENSE NO.
CT001973OtherPSYCHOLOGIST LICENSE NO.