Healthcare Provider Details

I. General information

NPI: 1124923107
Provider Name (Legal Business Name): SARAH W SMALL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 ACME RD
BREWER ME
04412-1544
US

IV. Provider business mailing address

343 DAMASCUS RD
CARMEL ME
04419-3426
US

V. Phone/Fax

Practice location:
  • Phone: 207-478-0963
  • Fax:
Mailing address:
  • Phone: 207-478-0963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT8496
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: