Healthcare Provider Details

I. General information

NPI: 1194649681
Provider Name (Legal Business Name): MRS. SARAH DIMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N STATE 89
PRESCOTT AZ
86313
US

IV. Provider business mailing address

1255 CLASSIC CT
CLARKDALE AZ
86324-3286
US

V. Phone/Fax

Practice location:
  • Phone: 928-300-9290
  • Fax:
Mailing address:
  • Phone: 928-300-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN186796
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: