Provider Demographics
NPI:1730968710
Name:KMOSKO, SARAH NOELLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NOELLE
Last Name:KMOSKO
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 1:1300 BULLDOG DR APT 403
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-0029
Mailing Address - Country:US
Mailing Address - Phone:910-233-0882
Mailing Address - Fax:
Practice Address - Street 1:13 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-1007
Practice Address - Country:US
Practice Address - Phone:828-649-9174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDA19199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health