Provider Demographics
NPI:1952792251
Name:MICKLEWRIGHT, SARAH URLACHER
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:URLACHER
Last Name:MICKLEWRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LINDSAY
Other - Last Name:URLACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7105 CROSSROADS BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7105 CROSSROADS BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2806
Practice Address - Country:US
Practice Address - Phone:615-969-8048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-14-15103103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst