Provider Demographics
NPI:1891556148
Name:FRALEIGH, SARAH (ASW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FRALEIGH
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 559 BOX 5663
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96377-0057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 5136
Practice Address - Street 2:CAMP MCTUREOUS
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96377
Practice Address - Country:US
Practice Address - Phone:909-547-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1006751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical