Provider Demographics
NPI:1083070726
Name:WEBB, SARAH LYN (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYN
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 STACIE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-5971
Mailing Address - Country:US
Mailing Address - Phone:281-744-6080
Mailing Address - Fax:
Practice Address - Street 1:1804 STACIE ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-5971
Practice Address - Country:US
Practice Address - Phone:281-744-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX109737OtherTEXAS STATE LICENSE FOR SPEECH-LANGUAGE PATHOLOGY