Provider Demographics
NPI:1972002756
Name:PATE, SARAH PRICKETT
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PRICKETT
Last Name:PATE
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 1:28 DOYLE DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2745
Mailing Address - Country:US
Mailing Address - Phone:803-261-1670
Mailing Address - Fax:833-541-1788
Practice Address - Street 1:8 E LODEN DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-4307
Practice Address - Country:US
Practice Address - Phone:864-334-6907
Practice Address - Fax:833-541-1788
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty