Provider Demographics
NPI:1285055863
Name:DEPASQUALE, SARAH ELEANOR (LM)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELEANOR
Last Name:DEPASQUALE
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:MILLHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:16854-0663
Mailing Address - Country:US
Mailing Address - Phone:814-574-8099
Mailing Address - Fax:814-349-2636
Practice Address - Street 1:137 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLHEIM
Practice Address - State:PA
Practice Address - Zip Code:16854
Practice Address - Country:US
Practice Address - Phone:814-574-8099
Practice Address - Fax:814-349-2636
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000025176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife