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NPI 1942920269

NPI 1942920269 : SARAH DEDRICK LMFT-D : SYRACUSE, NY

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General NPI Number Information
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    NPI Number           |    1942920269
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH DEDRICK LMFT-D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/29/2022
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    Last Update Date     |    11/05/2025
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Provider Practice Location Address
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    Address Line         |    601 ALLEN ST 
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    City                 |    SYRACUSE
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    State                |    NY
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    Zip                  |    13210-2669
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    Country              |    US
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    Telephone            |    315-552-1665
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    302 WEDGEWOOD TER 
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    City                 |    SYRACUSE
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    State                |    NY
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    Zip                  |    13214-1544
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    Country              |    US
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    Telephone            |    315-552-1665
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    Fax                  |    844-604-6200
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    001778
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    License Number State |    NY
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