Provider Demographics
NPI:1730552548
Name:POMMIER, SARAH JEAN (MS, MH16231)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:POMMIER
Suffix:
Gender:F
Credentials:MS, MH16231
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 LOUVRE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE ISLE
Mailing Address - State:FL
Mailing Address - Zip Code:32812-1028
Mailing Address - Country:US
Mailing Address - Phone:407-516-0625
Mailing Address - Fax:
Practice Address - Street 1:5120 LOUVRE AVE
Practice Address - Street 2:
Practice Address - City:BELLE ISLE
Practice Address - State:FL
Practice Address - Zip Code:32812
Practice Address - Country:US
Practice Address - Phone:407-516-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health