Provider Demographics
NPI:1013520170
Name:MEJIA, SARA (MA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:103 W GENERAL SCREVEN WAY
Mailing Address - Street 2:STE G PMB 1098
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-7462
Mailing Address - Country:US
Mailing Address - Phone:912-532-9774
Mailing Address - Fax:912-221-3085
Practice Address - Street 1:481 ELMA G MILES PKWY STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4004
Practice Address - Country:US
Practice Address - Phone:912-532-9774
Practice Address - Fax:912-221-3085
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-22-61475103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst