Provider Demographics
NPI:1174932297
Name:RIMACK, SARAH KATHLEEN
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHLEEN
Last Name:RIMACK
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 1:6080 SOUTHWARD AVE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-1436
Mailing Address - Country:US
Mailing Address - Phone:704-350-0323
Mailing Address - Fax:
Practice Address - Street 1:29500 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2030
Practice Address - Country:US
Practice Address - Phone:248-765-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent