Provider Demographics
NPI:1427305390
Name:ANDERSON, SARAH ELIZABETH (MA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W SUPERIOR ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-3000
Mailing Address - Country:US
Mailing Address - Phone:218-727-7353
Mailing Address - Fax:218-727-2646
Practice Address - Street 1:104 W SUPERIOR ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-3000
Practice Address - Country:US
Practice Address - Phone:218-727-7353
Practice Address - Fax:218-727-2646
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist