Provider Demographics
NPI:1316070386
Name:HERZBERG, SARAH ELIZABETH (MS)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HERZBERG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1935
Mailing Address - Country:US
Mailing Address - Phone:712-243-2606
Mailing Address - Fax:712-243-7811
Practice Address - Street 1:1500 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1935
Practice Address - Country:US
Practice Address - Phone:712-243-2606
Practice Address - Fax:712-243-7811
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA072185103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling