Provider Demographics
NPI:1194343350
Name:NGUYEN, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 E PECOS RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6077
Mailing Address - Country:US
Mailing Address - Phone:480-846-0607
Mailing Address - Fax:480-841-6696
Practice Address - Street 1:2141 E PECOS RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6077
Practice Address - Country:US
Practice Address - Phone:480-846-0607
Practice Address - Fax:480-841-6696
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31410225100000X, 2251P0200X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist