Provider Demographics
NPI:1952617599
Name:CLIFFORD, SARAH ANN (BA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SOUTH ST.
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143
Mailing Address - Country:US
Mailing Address - Phone:617-284-5130
Mailing Address - Fax:617-591-0239
Practice Address - Street 1:111 SOUTH ST.
Practice Address - Street 2:
Practice Address - City:SOMERVILLLE
Practice Address - State:MA
Practice Address - Zip Code:02143
Practice Address - Country:US
Practice Address - Phone:617-284-5130
Practice Address - Fax:617-591-0239
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program