Provider Demographics
NPI:1922390483
Name:LASHLEY, SARA TONI (CMT, LLCC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:TONI
Last Name:LASHLEY
Suffix:
Gender:F
Credentials:CMT, LLCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 FAHILY CIRCLE
Mailing Address - Street 2:P.O. BOX 1096
Mailing Address - City:SAN ANDREAS
Mailing Address - State:CA
Mailing Address - Zip Code:95249-1096
Mailing Address - Country:US
Mailing Address - Phone:209-304-4513
Mailing Address - Fax:
Practice Address - Street 1:472 FAHILY CIRCLE
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249-1096
Practice Address - Country:US
Practice Address - Phone:209-304-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist