Provider Demographics
NPI:1326501693
Name:WALKER, SARAH (LMT, CHC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMT, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:DEVENS
Mailing Address - State:MA
Mailing Address - Zip Code:01434-5616
Mailing Address - Country:US
Mailing Address - Phone:508-735-6727
Mailing Address - Fax:
Practice Address - Street 1:176 JACKSON RD
Practice Address - Street 2:
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434-5616
Practice Address - Country:US
Practice Address - Phone:508-735-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12983225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist