Provider Demographics
NPI:1083278386
Name:ST.MARTIN, SARAH BETH (HAS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:ST.MARTIN
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 BLANDING BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5065
Mailing Address - Country:US
Mailing Address - Phone:904-298-2855
Mailing Address - Fax:
Practice Address - Street 1:410 BLANDING BLVD STE 11
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5065
Practice Address - Country:US
Practice Address - Phone:904-298-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5378237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist