Provider Demographics
NPI:1447555255
Name:DAVIS, SARAH ELIZABETH (MT-BC, TEACHING CERT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MT-BC, TEACHING CERT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 BROOKMEADE CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-2051
Mailing Address - Country:US
Mailing Address - Phone:931-433-1265
Mailing Address - Fax:
Practice Address - Street 1:709 DAVIDSON ST.
Practice Address - Street 2:CENTERSTONE OF TENNESSEE, INC
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-463-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator