Provider Demographics
NPI:1932500584
Name:NOWAKOWSKI, SARA (PHD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:NOWAKOWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:M/C 0587
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-3996
Mailing Address - Fax:409-747-5127
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:M/C 0587
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0587
Practice Address - Country:US
Practice Address - Phone:409-772-3996
Practice Address - Fax:409-747-5127
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36908103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical