Doctor Name: | SARAH MARIE FITZGERALD |
NPI Number: | 1083072490 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLPC |
License Number: | L908633 |
Business Practice Address: | 677 E Main St Centreville, MI - 490328524 |
Business Phone Number: | 2694671000 |
Business Fax Number: | |
Mailing Address: | 2020 S 9th St, KALAMAZOO |
State: | MI |
Postal Code: | 490097908 |
Phone Number: | 2695985526 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2016 |
NPI Last Update Date: | 02/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | L908633 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |