Provider Demographics
NPI:1770078594
Name:WODDER, SARAH L (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:L
Last Name:WODDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 S MAIN ST STE 213
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4873
Mailing Address - Country:US
Mailing Address - Phone:215-345-8828
Mailing Address - Fax:215-348-3645
Practice Address - Street 1:350 S MAIN ST STE 213
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4873
Practice Address - Country:US
Practice Address - Phone:215-345-8828
Practice Address - Fax:215-348-3645
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009030101YP2500X
PAPS018525103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional