Provider Demographics
NPI:1528665718
Name:BREANT, SARAH (ND, LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BREANT
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N LEROUX ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3225
Mailing Address - Country:US
Mailing Address - Phone:602-753-7426
Mailing Address - Fax:
Practice Address - Street 1:705 N LEROUX ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3225
Practice Address - Country:US
Practice Address - Phone:602-753-7426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-011983171100000X
NMND-0011175F00000X
AZ22-1752175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist