Provider Demographics
NPI:1871097014
Name:WADHAMS, SABRINA MARIE
Entity type:Individual
Prefix:
First Name:SABRINA MARIE
Middle Name:
Last Name:WADHAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 SARATOGA BLVD APT 2601
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2190
Mailing Address - Country:US
Mailing Address - Phone:815-693-2968
Mailing Address - Fax:
Practice Address - Street 1:6901 SARATOGA BLVD APT 2601
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2190
Practice Address - Country:US
Practice Address - Phone:815-693-2968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst