MEDICARE: SARA PENNINGTON

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	106H00000X	Marriage & Family Therapist	1925	TN

General Provider Information

NPI Number	:	1447911581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA PENNINGTON

Provider Business Mailing Address
First Line	:	969 OAK RIDGE TPKE # 286
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-8832
Country	:	US
Telephone Number	:	865-505-1440
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 ROBERTSVILLE RD STE A
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-5057
Country	:	US
Telephone Number	:	865-505-1440
Fax Number	:

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

Provider Enumeration Date	:	12/30/2021
Last Update Date	:	12/30/2021

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Directions to “ SARA PENNINGTON ” Practice Location

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