Provider Demographics
NPI:1780139584
Name:RAYBURN, SARAH MILLER (PHD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MILLER
Last Name:RAYBURN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:JOANNE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:200 HENRY CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5720
Mailing Address - Country:US
Mailing Address - Phone:504-896-7272
Mailing Address - Fax:504-896-7273
Practice Address - Street 1:200 HENRY CLAY AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5720
Practice Address - Country:US
Practice Address - Phone:504-896-7272
Practice Address - Fax:504-896-7273
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1432103T00000X, 103TS0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool