Provider Demographics
NPI:1962540211
Name:NEAL, SARA ANN (PSYD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:NEAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 S FREMONT AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2295
Mailing Address - Country:US
Mailing Address - Phone:417-820-3707
Mailing Address - Fax:
Practice Address - Street 1:1965 S FREMONT AVE STE 310
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2295
Practice Address - Country:US
Practice Address - Phone:417-820-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009030821103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist