Provider Demographics
NPI:1558096040
Name:MARTIN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5490 N LITTLE RIVER LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1768
Mailing Address - Country:US
Mailing Address - Phone:520-465-9318
Mailing Address - Fax:
Practice Address - Street 1:445 E GLENHURST DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85704-6631
Practice Address - Country:US
Practice Address - Phone:520-591-9196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician