Provider Demographics
NPI:1033456041
Name:VARN, SARA STUCKEY (SLT)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:STUCKEY
Last Name:VARN
Suffix:
Gender:F
Credentials:SLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-0507
Mailing Address - Country:US
Mailing Address - Phone:803-484-5337
Mailing Address - Fax:803-483-0131
Practice Address - Street 1:521 PARK ST
Practice Address - Street 2:POST OFFICE BOX 507
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010-1133
Practice Address - Country:US
Practice Address - Phone:803-484-5337
Practice Address - Fax:803-483-0131
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC198193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist