Provider Demographics
NPI:1942704218
Name:TINNESZ, SARA
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:TINNESZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 ARGYLE FOREST BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6601
Mailing Address - Country:US
Mailing Address - Phone:904-563-5875
Mailing Address - Fax:904-696-9868
Practice Address - Street 1:6339 ARGYLE FOREST BLVD STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6601
Practice Address - Country:US
Practice Address - Phone:904-563-5875
Practice Address - Fax:904-696-9868
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst