Provider Demographics
NPI:1891218897
Name:DOVER, SARAH BUMGARNER
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:BUMGARNER
Last Name:DOVER
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 1:3809 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-3533
Mailing Address - Country:US
Mailing Address - Phone:803-786-1844
Mailing Address - Fax:
Practice Address - Street 1:3809 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3533
Practice Address - Country:US
Practice Address - Phone:803-786-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty