Provider Demographics
NPI:1861190274
Name:MOLD, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:MOLD
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 1:2440 NORTH ESSEX AVE
Mailing Address - Street 2:
Mailing Address - City:CIRTUS HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34442-5028
Mailing Address - Country:US
Mailing Address - Phone:352-558-8054
Mailing Address - Fax:
Practice Address - Street 1:2440 NORTH ESSEX AVE
Practice Address - Street 2:
Practice Address - City:CIRTUS HILLS
Practice Address - State:FL
Practice Address - Zip Code:34442-6750
Practice Address - Country:US
Practice Address - Phone:352-558-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician