Provider Demographics
NPI:1396929915
Name:VALE, SARA O (PHD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:O
Last Name:VALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 JOHNNIE DODDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3190
Mailing Address - Country:US
Mailing Address - Phone:843-884-7747
Mailing Address - Fax:
Practice Address - Street 1:886 JOHNNIE DODDS BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3190
Practice Address - Country:US
Practice Address - Phone:843-884-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional