Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 001808 | CT |
N | 101YS0200X | School Counselor | C112013001282 | CT |
NPI | 1063843860 |
---|---|
Provider Name | Sara Callahan |
First Address | Norwalk, CT 06854-2111 |
Second Address | Darien, CT 06820-4732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2013 |
Last Update Date | 03/12/2013 |