Provider Demographics
NPI:1417590290
Name:GRANAHAN, SARAH LYN (HTP-A, RMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:GRANAHAN
Suffix:
Gender:F
Credentials:HTP-A, RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11728 PACESFERRY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-9076
Mailing Address - Country:US
Mailing Address - Phone:847-361-5744
Mailing Address - Fax:
Practice Address - Street 1:107 WINDEL DR STE 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4471
Practice Address - Country:US
Practice Address - Phone:847-361-5744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist