Provider Demographics
NPI:1699571190
Name:MCGUIRE, SALLIE ANNE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:SALLIE
Middle Name:ANNE
Last Name:MCGUIRE
Suffix:
Gender:
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:SALLIE
Other - Middle Name:A
Other - Last Name:MCGUIRE-STALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NBC-HWC
Mailing Address - Street 1:2425 SWEET HOME RD STE B
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2233
Mailing Address - Country:US
Mailing Address - Phone:716-609-9141
Mailing Address - Fax:888-976-5853
Practice Address - Street 1:2425 SWEET HOME RD STE B
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2233
Practice Address - Country:US
Practice Address - Phone:716-609-9141
Practice Address - Fax:888-976-5853
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA-4045187171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach