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General NPI Number Information
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NPI Number | 1063954410
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Entity Type | Organization
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Legal Business Name | SARAH PIRES, PSYD, LLC
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 451 STATE ST STE B2
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3070
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Country | US
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Telephone | 203-915-7304
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Fax |
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Provider Business Mailing Address
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Address Line | 451 STATE ST STE B2
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3070
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Country | US
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Telephone | 203-915-7304
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. SARAH PIRES
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Credential | PSY.D.
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Telephone | 203-915-7304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 003211
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License Number State | CT
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