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General NPI Number Information
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NPI Number | 1821604307
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Entity Type | Individual
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Provider Name | SARAH HOLDER CMT
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Gender | Female
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Dates
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Enumeration Date | 09/19/2020
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Last Update Date | 09/19/2020
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Provider Practice Location Address
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Address Line | 45 W 45TH ST
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City | NEW YORK
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State | NY
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Zip | 10036-4602
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Country | US
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Telephone | 503-270-1647
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8203
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City | EMERYVILLE
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State | CA
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Zip | 94662-0203
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Country | US
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Telephone | 503-270-1647
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 50812
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License Number State | CA
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