Healthcare Provider Details

I. General information

NPI: 1063969095
Provider Name (Legal Business Name): SARAH C RISPINTO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE C21
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE C21
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-6178
  • Fax: 216-636-2175
Mailing address:
  • Phone: 216-444-6178
  • Fax: 216-636-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number7491
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: