Provider Demographics
NPI:1134777246
Name:NOBLE, SARA ALYSON LEIGHANNE (DPT, PT, ATC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ALYSON LEIGHANNE
Last Name:NOBLE
Suffix:
Gender:F
Credentials:DPT, PT, ATC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SELF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:10517 BRADDOCK RD STE D
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2275
Mailing Address - Country:US
Mailing Address - Phone:571-351-5618
Mailing Address - Fax:
Practice Address - Street 1:10517 BRADDOCK RD STE D
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-2275
Practice Address - Country:US
Practice Address - Phone:571-351-5618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-01
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216937225100000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer