Healthcare Provider Details

I. General information

NPI: 1992452015
Provider Name (Legal Business Name): SARA MARTIN LMT, MSACN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 E VALLEY RD STE B
PRESCOTT VALLEY AZ
86314-8742
US

IV. Provider business mailing address

8600 E VALLEY RD STE B
PRESCOTT VALLEY AZ
86314-8742
US

V. Phone/Fax

Practice location:
  • Phone: 928-224-8478
  • Fax:
Mailing address:
  • Phone: 928-499-8271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT26677
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberLEHP850
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: