Provider Demographics
NPI:1174359616
Name:ROYAL, SARAH ASHLEY (NCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ASHLEY
Last Name:ROYAL
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 OAK DR
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35956-2605
Mailing Address - Country:US
Mailing Address - Phone:256-399-1378
Mailing Address - Fax:
Practice Address - Street 1:4400 BAYOU BLVD STE 20
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-1908
Practice Address - Country:US
Practice Address - Phone:850-583-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health