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General NPI Number Information
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NPI Number | 1356139745
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Entity Type | Individual
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Provider Name | SARAH MADISON TATE
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Gender | Female
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 704 E 4TH AVE
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City | POST FALLS
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State | ID
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Zip | 83854-7559
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Country | US
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Telephone | 107-520-8676
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Fax |
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Provider Business Mailing Address
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Address Line | 7639A WASHINGTON AVE
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City | FAIRCHILD AFB
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State | WA
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Zip | 99011-3022
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Country | US
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Telephone | 870-668-0229
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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 |
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License Number State |
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