Provider Demographics
NPI:1366225989
Name:SAWYERS, PAULINE S (PHD)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:S
Last Name:SAWYERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-0363
Mailing Address - Country:US
Mailing Address - Phone:256-277-1797
Mailing Address - Fax:
Practice Address - Street 1:4120 THORNTON TAYLOR PKWY STE G
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-2292
Practice Address - Country:US
Practice Address - Phone:256-277-1797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2354103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical