Provider Demographics
NPI:1376964833
Name:DAMIANI, SARAH (LAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DAMIANI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 DEFENSE HWY STE 401
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2943
Mailing Address - Country:US
Mailing Address - Phone:410-697-1235
Mailing Address - Fax:410-774-4435
Practice Address - Street 1:2191 DEFENSE HWY STE 401
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2943
Practice Address - Country:US
Practice Address - Phone:410-697-1235
Practice Address - Fax:410-774-4435
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01949171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist