Provider Demographics
NPI:1881474971
Name:MILLY, SARA B (MFT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:B
Last Name:MILLY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 WESTVIEW ST APT A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3718
Mailing Address - Country:US
Mailing Address - Phone:276-704-9196
Mailing Address - Fax:
Practice Address - Street 1:1025 WESTVIEW ST APT A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3718
Practice Address - Country:US
Practice Address - Phone:276-704-9196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health