Provider Demographics
NPI:1316548217
Name:BARRIOS, SARAH ELENA (LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELENA
Last Name:BARRIOS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PAISLEY CT APT A
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-7327
Mailing Address - Country:US
Mailing Address - Phone:617-755-4299
Mailing Address - Fax:
Practice Address - Street 1:101 PAISLEY CT APT A
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-7327
Practice Address - Country:US
Practice Address - Phone:617-755-4299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18138225700000X
CA70997225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist