Provider Demographics
NPI:1053143883
Name:ROBERTSON, SARAH LOUISE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:ROBERTSON
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 1:471 W 36TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5853
Mailing Address - Country:US
Mailing Address - Phone:907-903-7123
Mailing Address - Fax:
Practice Address - Street 1:471 W 36TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5853
Practice Address - Country:US
Practice Address - Phone:907-903-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health