Provider Demographics
NPI:1013443142
Name:TREAT, SARAH (MS, CCN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TREAT
Suffix:
Gender:F
Credentials:MS, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16535 HUEBNER, SUITE 112
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248
Mailing Address - Country:US
Mailing Address - Phone:210-455-7892
Mailing Address - Fax:
Practice Address - Street 1:16535 HUEBNER, SUITE 112
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248
Practice Address - Country:US
Practice Address - Phone:210-455-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3963133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3963OtherCCN