Provider Demographics
NPI:1386357036
Name:ALLIE, SARAH (LLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ALLIE
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BAILEY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4688
Mailing Address - Country:US
Mailing Address - Phone:517-273-2706
Mailing Address - Fax:
Practice Address - Street 1:300 BAILEY ST STE 2
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4688
Practice Address - Country:US
Practice Address - Phone:517-273-2706
Practice Address - Fax:517-798-5677
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361005097103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical