Provider Demographics
NPI:1841948148
Name:DELVASTO, SARA GABRIELLE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:GABRIELLE
Last Name:DELVASTO
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:GABRIELLE
Other - Last Name:COWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:2212 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6011
Mailing Address - Country:US
Mailing Address - Phone:910-332-3660
Mailing Address - Fax:910-762-0569
Practice Address - Street 1:2212 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6011
Practice Address - Country:US
Practice Address - Phone:910-332-3660
Practice Address - Fax:910-762-0569
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS