Provider Demographics
NPI:1114483062
Name:PLOTKIN, SARA A (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:PLOTKIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 CURITIBA CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1454
Mailing Address - Country:US
Mailing Address - Phone:678-827-6727
Mailing Address - Fax:678-487-8801
Practice Address - Street 1:3470 CURITIBA CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1454
Practice Address - Country:US
Practice Address - Phone:678-827-6727
Practice Address - Fax:678-487-8801
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty