Provider Demographics
NPI:1902910136
Name:THIEN, SARAH LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYNN
Last Name:THIEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4717 QUEMAZON
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-6600
Mailing Address - Country:US
Mailing Address - Phone:505-662-2225
Mailing Address - Fax:
Practice Address - Street 1:4717 QUEMAZON
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-6600
Practice Address - Country:US
Practice Address - Phone:505-662-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI12121481OtherAMERICAN MEDICAL
NMNM00Q534OtherBLUE CROSS/BLUE SHIELD
UT233792OtherUNITED HEALTH CARE