Healthcare Provider Details

I. General information

NPI: 1619718814
Provider Name (Legal Business Name): SARAH TAGGART THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 BOSTON POST RD W STE 420
MARLBOROUGH MA
01752-1867
US

IV. Provider business mailing address

16 SILK ST
ARLINGTON MA
02474-3819
US

V. Phone/Fax

Practice location:
  • Phone: 774-701-7475
  • Fax:
Mailing address:
  • Phone: 801-641-1372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: