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General NPI Number Information
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NPI Number | 1114379724
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Entity Type | Individual
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Provider Name | SARA L WASSERMAN BS, MA, LPC, ATR
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Gender | Female
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 14843 W SPRAGUE RD #A
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City | STRONGSVILLE
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State | OH
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Zip | 44136-6601
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Country | US
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Telephone | 440-234-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 14843 W SPRAGUE RD #A
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City | STRONGSVILLE
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State | OH
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Zip | 44136-6601
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Country | US
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Telephone | 440-234-9955
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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 | C.0004496
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License Number State | OH
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