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General NPI Number Information
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NPI Number | 1457917965
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Entity Type | Individual
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Provider Name | MS. SARAH MANDEL
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Gender | Female
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 4009 BANISTER LN STE 355
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City | AUSTIN
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State | TX
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Zip | 78704-7040
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Country | US
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Telephone | 512-712-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 10500 S INTERSTATE 35 APT 9305
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City | AUSTIN
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State | TX
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Zip | 78748-0043
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Country | US
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Telephone | 301-642-2944
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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 | 77759
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License Number State | TX
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