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General NPI Number Information
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NPI Number | 1003426446
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Entity Type | Individual
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Provider Name | SARA STAMM
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 4493 WOODBINE RD
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City | PACE
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State | FL
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Zip | 32571-8726
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Country | US
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Telephone | 850-400-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 4823 RED OAK DR
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City | MILTON
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State | FL
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Zip | 32583-2767
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Country | US
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Telephone | 210-980-0754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH25670
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC05672
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60776710
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License Number State | WA
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