Provider Demographics
NPI:1871208470
Name:PRESTON, SARAH (LMT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:PRESTON
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 1:24 PUTNAM PIKE STE 3
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241-1647
Mailing Address - Country:US
Mailing Address - Phone:860-412-9016
Mailing Address - Fax:
Practice Address - Street 1:24 PUTNAM PIKE STE 3
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-1647
Practice Address - Country:US
Practice Address - Phone:860-412-9016
Practice Address - Fax:860-412-9053
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10620225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist