| Doctor Name: | SARAH RANDOLPH HIXSON |
| NPI Number: | 1245406016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 24 Country Club Lane Pinedale, WY - 82941 |
| Business Phone Number: | 3073672111 |
| Business Fax Number: | 3073672166 |
| Mailing Address: | Po Box 856, PINEDALE |
| State: | WY |
| Postal Code: | 829410856 |
| Phone Number: | 3073672111 |
| Fax Number: | 3073672166 |
| NPI Enumeration Date: | 05/01/2008 |
| NPI Last Update Date: | 12/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |