Provider Demographics
NPI:1255940201
Name:RAVA, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RAVA
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 1:2681 RIDGEBURY RD
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-9703
Mailing Address - Country:US
Mailing Address - Phone:570-995-1296
Mailing Address - Fax:
Practice Address - Street 1:425 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:PA
Practice Address - Zip Code:17724-1633
Practice Address - Country:US
Practice Address - Phone:570-673-8662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor