Provider Demographics
NPI:1952147415
Name:URDA, SARAH ELISABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELISABETH
Last Name:URDA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ELISABETH
Other - Last Name:BUETOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:5508 NELSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-7237
Mailing Address - Country:US
Mailing Address - Phone:502-380-6165
Mailing Address - Fax:
Practice Address - Street 1:5508 NELSON OAKS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-7237
Practice Address - Country:US
Practice Address - Phone:502-380-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40209103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical