Provider Demographics
NPI:1487950291
Name:SANABRIA, TATIANNA (MACOM, LAC)
Entity type:Individual
Prefix:MRS
First Name:TATIANNA
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:F
Credentials:MACOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E CHATHAM ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3484
Mailing Address - Country:US
Mailing Address - Phone:919-638-1001
Mailing Address - Fax:
Practice Address - Street 1:404 E CHATHAM ST
Practice Address - Street 2:SUITE A
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3484
Practice Address - Country:US
Practice Address - Phone:919-638-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist