Provider Demographics
NPI:1699269878
Name:CLAY, SARAH GRACE (BA, IBCLC, RLC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:CLAY
Suffix:
Gender:F
Credentials:BA, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 S KYRENE RD STE 125
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2172
Mailing Address - Country:US
Mailing Address - Phone:480-442-8491
Mailing Address - Fax:480-820-2808
Practice Address - Street 1:8400 S KYRENE RD STE 125
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2172
Practice Address - Country:US
Practice Address - Phone:480-442-8491
Practice Address - Fax:480-820-2808
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL-141811174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN