Provider Demographics
NPI:1952175267
Name:LYON, SARAH JILL (RRT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JILL
Last Name:LYON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BOOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT
Mailing Address - Street 1:PO BOX 1422
Mailing Address - Street 2:
Mailing Address - City:MORIARTY
Mailing Address - State:NM
Mailing Address - Zip Code:87035-1422
Mailing Address - Country:US
Mailing Address - Phone:505-681-2444
Mailing Address - Fax:
Practice Address - Street 1:#10 BULLARD RD.
Practice Address - Street 2:
Practice Address - City:MORIARTY
Practice Address - State:NM
Practice Address - Zip Code:87035
Practice Address - Country:US
Practice Address - Phone:505-681-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2087227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered