Provider Demographics
NPI:1215309620
Name:DRUMMOND, SARAH WATTS (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:WATTS
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2219
Mailing Address - Country:US
Mailing Address - Phone:318-869-1632
Mailing Address - Fax:
Practice Address - Street 1:707 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2219
Practice Address - Country:US
Practice Address - Phone:318-869-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-24
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36667103TC0700X
LA1365103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical