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General NPI Number Information
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NPI Number | 1669508644
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Entity Type | Individual
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Provider Name | SARA RAFFERTY LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 375 DOUGLAS AVE STE 2005
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3315
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Country | US
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Telephone | 407-529-5359
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Fax | 407-682-4405
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Provider Business Mailing Address
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Address Line | 1384 BLACK WILLOW TRL
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1156
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Country | US
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Telephone | 407-927-0937
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Fax | 407-682-4405
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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 | MH 5551
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License Number State | FL
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