Provider Demographics
NPI:1083013254
Name:VILLARET, SARAH JANE (MS SLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH JANE
Middle Name:
Last Name:VILLARET
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 SAINTFIELD PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0339
Mailing Address - Country:US
Mailing Address - Phone:352-397-6483
Mailing Address - Fax:
Practice Address - Street 1:2918 SAINTFIELD PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0339
Practice Address - Country:US
Practice Address - Phone:352-397-6483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSLP5546235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist