Provider Demographics
NPI:1851501324
Name:REYBURN, SARAH L (MLFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:REYBURN
Suffix:
Gender:F
Credentials:MLFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 RUSSELLS PATH
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2604
Mailing Address - Country:US
Mailing Address - Phone:508-896-4843
Mailing Address - Fax:508-896-8408
Practice Address - Street 1:14 COVE RD
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-2443
Practice Address - Country:US
Practice Address - Phone:508-896-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1182106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist