Provider Demographics
NPI:1336518521
Name:SIDDIQUI, SARAH (MS, LCGC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4186 RIVERHILL CT NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1995
Mailing Address - Country:US
Mailing Address - Phone:260-402-3295
Mailing Address - Fax:
Practice Address - Street 1:320 KENNESTONE HOSPITAL BLVD STE 216
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1140
Practice Address - Country:US
Practice Address - Phone:470-793-7472
Practice Address - Fax:770-999-2323
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS