Provider Demographics
NPI:1811609605
Name:RAY, SARAH ELIZABETH (LMT)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:RAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2824
Mailing Address - Country:US
Mailing Address - Phone:703-489-5324
Mailing Address - Fax:
Practice Address - Street 1:4401 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2824
Practice Address - Country:US
Practice Address - Phone:703-489-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019013256225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty