Provider Demographics
NPI:1750641767
Name:STEVENS, SARAH E (LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:STEVENS
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 1:609 ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2003
Mailing Address - Country:US
Mailing Address - Phone:412-828-0700
Mailing Address - Fax:412-828-9140
Practice Address - Street 1:609 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-2003
Practice Address - Country:US
Practice Address - Phone:412-828-0700
Practice Address - Fax:412-828-9140
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG005213225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMSG005213OtherSTATE LICENSE