Provider Information for 1194358721
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SARA NOVEMBER LISW-S
Sex: Female
NPI: 1194358721
Last Updated: 2020-02-21
Certification Date: 2020-02-21
Certification Date: 2020-02-21
Details
| Name | Value | ||||||||
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| NPI | 1194358721 | ||||||||
| Enumeration Date | 2020-02-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 38882 MENTOR AVE WILLOUGHBY, OH 44094-7875 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 38882 MENTOR AVE WILLOUGHBY, OH 44094-7875 United States Phone: 440-578-8200 | Fax: | ||||||||
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