Provider Demographics
NPI:1639652449
Name:BARKER, SARA LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LYNN
Last Name:BARKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PARADISE BLVD NW STE 112
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6152
Mailing Address - Country:US
Mailing Address - Phone:870-504-1744
Mailing Address - Fax:
Practice Address - Street 1:4601 PARADISE BLVD NW STE 112
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-6152
Practice Address - Country:US
Practice Address - Phone:870-504-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-08
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8307225700000X
SD8982225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist