Basic Information
| Provider Information | |||||||||
| NPI: | 1801234125 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOAGUE | ||||||||
| FirstName: | SARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 VFW PKWY | ||||||||
| Address2: | STE 6 | ||||||||
| City: | WEST ROXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021321332 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 HIGHLAND AVE | ||||||||
| Address2: | NSCH | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019702141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783542700 | ||||||||
| FaxNumber: | 9787404902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2013 | ||||||||
| LastUpdateDate: | 09/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.