Provider Demographics
NPI:1245554005
Name:MUTTER, SARAH E
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:MUTTER
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 1:31 BRIARCREST DR
Mailing Address - Street 2:
Mailing Address - City:ROSE VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6710
Mailing Address - Country:US
Mailing Address - Phone:916-539-2576
Mailing Address - Fax:
Practice Address - Street 1:31 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:ROSE VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19086-6710
Practice Address - Country:US
Practice Address - Phone:916-539-2576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA659001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical