Healthcare Provider Details

I. General information

NPI: 1568265734
Provider Name (Legal Business Name): SARAH BRASHEAR IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 E SOUTHERN AVE STE 3A
MESA AZ
85204-5247
US

IV. Provider business mailing address

3389 S TATUM CT
GILBERT AZ
85297-7809
US

V. Phone/Fax

Practice location:
  • Phone: 480-235-8473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-317110
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: