Provider Demographics
NPI:1043484017
Name:MCNULTY, SARAH (BS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCNULTY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2911
Mailing Address - Country:US
Mailing Address - Phone:336-387-6161
Mailing Address - Fax:336-387-9167
Practice Address - Street 1:902 BONNER DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8948
Practice Address - Country:US
Practice Address - Phone:336-387-6161
Practice Address - Fax:336-387-9167
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health