Provider Demographics
NPI:1598927600
Name:PRESTON, SARAH VALENTINE (CMT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:VALENTINE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6639 LOCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1645
Mailing Address - Country:US
Mailing Address - Phone:410-296-4313
Mailing Address - Fax:
Practice Address - Street 1:658 KENILWORTH DR STE 206
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2334
Practice Address - Country:US
Practice Address - Phone:410-828-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM03098225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist