Provider Demographics
NPI:1780110841
Name:KALIA, SARAH (SCM, LCGC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KALIA
Suffix:
Gender:F
Credentials:SCM, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CANAL PARK APT 310
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-2212
Mailing Address - Country:US
Mailing Address - Phone:857-600-1312
Mailing Address - Fax:
Practice Address - Street 1:6 CANAL PARK APT 310
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-2212
Practice Address - Country:US
Practice Address - Phone:857-600-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAGC169170300000X
CAGC000598170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS