Provider Demographics
NPI:1013038058
Name:CONNELL, SARAH BRIE (MFT INTERN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:BRIE
Last Name:CONNELL
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 VICEROY DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8209
Mailing Address - Country:US
Mailing Address - Phone:530-892-1364
Mailing Address - Fax:
Practice Address - Street 1:10 INDEPENDENCE CIR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0210
Practice Address - Country:US
Practice Address - Phone:530-345-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51851106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist