Provider Demographics
NPI:1063260214
Name:KING, SARAH KIMBERLY (LPMT, MT-BC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KIMBERLY
Last Name:KING
Suffix:
Gender:F
Credentials:LPMT, MT-BC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:KIMBERLY
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10308 LESLIE ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4858
Mailing Address - Country:US
Mailing Address - Phone:607-972-1465
Mailing Address - Fax:
Practice Address - Street 1:3930 KNOWLES AVE STE 306
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2428
Practice Address - Country:US
Practice Address - Phone:847-907-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00132225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist