Provider Demographics
NPI:1972972255
Name:DELMARMOL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DELMARMOL
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 1:188 RONALD BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2738
Mailing Address - Country:US
Mailing Address - Phone:504-442-1163
Mailing Address - Fax:
Practice Address - Street 1:111 S SAINT ANTOINE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-4743
Practice Address - Country:US
Practice Address - Phone:337-231-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health