Provider Demographics
NPI:1245825603
Name:ROBERTS, SARAH JOY (MOM, LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JOY
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A COMMONS DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3448
Mailing Address - Country:US
Mailing Address - Phone:603-425-0044
Mailing Address - Fax:
Practice Address - Street 1:1A COMMONS DR UNIT 4
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3448
Practice Address - Country:US
Practice Address - Phone:603-425-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-07
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHACP026171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty