Provider Demographics
NPI:1881105815
Name:BENNETT, SARAH CECILIA (NMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CECILIA
Last Name:BENNETT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 N 52ND ST APT 2312
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7944
Mailing Address - Country:US
Mailing Address - Phone:574-850-4449
Mailing Address - Fax:
Practice Address - Street 1:3226 N MILLER RD STE 5
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6930
Practice Address - Country:US
Practice Address - Phone:480-630-9093
Practice Address - Fax:480-485-9198
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17-1666175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath