Provider Demographics
NPI:1215255369
Name:GUERTIN, SARAH CHRISTINE (MA, LLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:CHRISTINE
Last Name:GUERTIN
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15501 METROPOLITAN PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1684
Mailing Address - Country:US
Mailing Address - Phone:586-226-2282
Mailing Address - Fax:586-226-2833
Practice Address - Street 1:15501 METROPOLITAN PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-1684
Practice Address - Country:US
Practice Address - Phone:586-226-2282
Practice Address - Fax:586-226-2833
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301014349103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910681OtherBLUE CROSS