Provider Demographics
NPI:1497631048
Name:KWAWU, SARAH (L-CAT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:KWAWU
Suffix:
Gender:F
Credentials:L-CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 KERRYBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2524
Mailing Address - Country:US
Mailing Address - Phone:252-314-8461
Mailing Address - Fax:
Practice Address - Street 1:2922 AUDREY DR STE 102
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7268
Practice Address - Country:US
Practice Address - Phone:252-314-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001759221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist