MEDICARE: DR. SARAH ANN FEUERBACHER WELLS PH.D., LCSW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	36001	TX

General Provider Information

NPI Number	:	1073849378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ANN FEUERBACHER WELLS PH.D., LCSW-S

Provider Business Mailing Address
First Line	:	7608 WORTHING ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6447
Country	:	US
Telephone Number	:	214-801-4942
Fax Number	:

Provider Business Practice Location Address
First Line	:	7608 WORTHING ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6447
Country	:	US
Telephone Number	:	214-801-4942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	10/22/2009

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