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General NPI Number Information
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NPI Number | 1730371139
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Entity Type | Individual
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Provider Name | SARA NOVAK LCSW-C, MAC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 7300 GRACE DR STE A
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City | COLUMBIA
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State | MD
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Zip | 21044-2473
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Country | US
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Telephone | 443-312-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 3172 SAINT JOHNS LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-2602
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Country | US
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Telephone | 443-900-3177
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U02887
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License Number State | MD
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