Healthcare Provider Details

I. General information

NPI: 1699116293
Provider Name (Legal Business Name): SARAH CRANBURY M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HUEBNER RD
FORT RILEY KS
66442-4030
US

IV. Provider business mailing address

AM RATHAUS 12
WIESBADEN HESSEN
65207
DE

V. Phone/Fax

Practice location:
  • Phone: 785-240-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW79413
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: