Provider Demographics
NPI:1952479628
Name:DETTMER, SARAH K (MSED, MS, PLPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:DETTMER
Suffix:
Gender:F
Credentials:MSED, MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21350 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5413
Mailing Address - Country:US
Mailing Address - Phone:913-322-2400
Mailing Address - Fax:913-621-5730
Practice Address - Street 1:21350 W 153RD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5413
Practice Address - Country:US
Practice Address - Phone:913-322-2400
Practice Address - Fax:913-621-5730
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007034757101YM0800X
KS1036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health