Basic Information
Provider Information
NPI: 1437458858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RULMAN
FirstName: SARAH
MiddleName: KATHLEEN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 899 RIVERSIDE ST
Address2:  
City: PORTLAND
State: ME
PostalCode: 041031070
CountryCode: US
TelephoneNumber: 2078711200
FaxNumber: 2078711232
Practice Location
Address1: 50 PARK RD STE 4
Address2:  
City: WESTBROOK
State: ME
PostalCode: 040923176
CountryCode: US
TelephoneNumber: 2072404709
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2011
LastUpdateDate: 10/19/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XLSX12971MEY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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