Provider Demographics
NPI:1982918439
Name:SHOFFSTALL, SARAH (MS)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:SHOFFSTALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11108 LAKERIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2452
Mailing Address - Country:US
Mailing Address - Phone:405-440-1006
Mailing Address - Fax:
Practice Address - Street 1:7908 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-4950
Practice Address - Country:US
Practice Address - Phone:405-440-1006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor