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General NPI Number Information
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NPI Number | 1831827484
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Entity Type | Individual
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Provider Name | SARA J STOCKWELL ED.S.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 1070 COMMERCE DR STE 301
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City | PERRYSBURG
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State | OH
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Zip | 43551-5284
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Country | US
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Telephone | 419-931-3029
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Fax |
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Provider Business Mailing Address
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Address Line | 475 E WATER ST
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City | OAK HARBOR
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State | OH
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Zip | 43449-1534
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Country | US
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Telephone | 419-261-7272
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | SP.00693
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SP.00693
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License Number State | OH
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