Provider Demographics
NPI:1457717357
Name:JEANETTE SARBO PHD PLLC
Entity Type:Organization
Organization Name:JEANETTE SARBO PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SARBO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-408-0220
Mailing Address - Street 1:180 PROVIDENCE RD
Mailing Address - Street 2:SUITE #9
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2206
Mailing Address - Country:US
Mailing Address - Phone:919-408-0220
Mailing Address - Fax:
Practice Address - Street 1:180 PROVIDENCE RD
Practice Address - Street 2:SUITE #9
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2206
Practice Address - Country:US
Practice Address - Phone:919-408-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1335103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty