Doctor Name: | DR. SARA ANN VILLARREAL |
NPI Number: | 1417218041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 1817 |
Business Practice Address: | 1060 Gaffney Rd #7440 Ft Wainwright, AK - 997035001 |
Business Phone Number: | 9073615603 |
Business Fax Number: | |
Mailing Address: | 1060 Gaffney Rd, #7440 FT WAINWRIGHT |
State: | AK |
Postal Code: | 997035001 |
Phone Number: | 9073615603 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2012 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1817 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |