Provider Demographics
NPI:1588300610
Name:BREAUX, SARAH IVALUE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:IVALUE
Last Name:BREAUX
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 1:3265 E TROPICANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7386
Mailing Address - Country:US
Mailing Address - Phone:702-577-1910
Mailing Address - Fax:888-481-1462
Practice Address - Street 1:3265 E TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7386
Practice Address - Country:US
Practice Address - Phone:702-577-1910
Practice Address - Fax:888-481-1462
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2033171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist