Individual
SARA SCULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 S 17TH ST STE 1008, PHILADELPHIA, PA 19103-6210
(215) 840-3554
Mailing address
255 S 17TH ST STE 1008, PHILADELPHIA, PA 19103-6210
(484) 794-1001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/13/2022
Last updated
09/13/2022
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