Provider Information for 1629447362
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Mrs. SARA LABELLE M.S., LPC
Sex: Female
NPI: 1629447362
Last Updated: 2020-11-20
Certification Date: 2020-11-18
Certification Date: 2020-11-18
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629447362 | ||||||||||||||
| Enumeration Date | 2015-09-23 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 19401 NORTHLINE RD SOUTHGATE, MI 48195-2277 United States Phone: 734-626-1183 | Fax: | ||||||||||||||
| Primary Practice Address | 19401 NORTHLINE RD SOUTHGATE, MI 48195-2277 United States Phone: 346-261-1837 | Fax: | ||||||||||||||
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