Provider Demographics
NPI:1386456184
Name:WALDEN, SARAH ELIZABETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:WALDEN
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 1:3224 MOUNT LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:SC
Mailing Address - Zip Code:29321-2831
Mailing Address - Country:US
Mailing Address - Phone:864-441-3638
Mailing Address - Fax:
Practice Address - Street 1:3224 MOUNT LEBANON RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:SC
Practice Address - Zip Code:29321-2831
Practice Address - Country:US
Practice Address - Phone:864-441-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program