Provider Demographics
NPI:1003142928
Name:DUBBE, SARAH JEAN (CMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:DUBBE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 BROWN COURT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503
Mailing Address - Country:US
Mailing Address - Phone:303-684-9290
Mailing Address - Fax:303-772-9308
Practice Address - Street 1:1690 BROWN COURT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:303-684-9290
Practice Address - Fax:303-772-9308
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4310225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist