Healthcare Provider Details

I. General information

NPI: 1588581912
Provider Name (Legal Business Name): SARA SUGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 HICKORY TREE RD APT B
WINSTON SALEM NC
27127-9142
US

IV. Provider business mailing address

1305 HICKORY TREE RD APT B
WINSTON SALEM NC
27127-9142
US

V. Phone/Fax

Practice location:
  • Phone: 336-870-3030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number791630
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: