Provider Demographics
NPI:1194576314
Name:SARACAY PENA, SARAHI
Entity type:Individual
Prefix:
First Name:SARAHI
Middle Name:
Last Name:SARACAY PENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9941 LINGO LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3349
Mailing Address - Country:US
Mailing Address - Phone:972-503-4108
Mailing Address - Fax:
Practice Address - Street 1:9941 LINGO LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3349
Practice Address - Country:US
Practice Address - Phone:720-346-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88060101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional