Provider Demographics
NPI:1174665939
Name:PERKINS, SARA MEE JEONG (MA)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:MEE JEONG
Last Name:PERKINS
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 1:9225 E TANQUE VERDE RD
Mailing Address - Street 2:APT 4201
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8718
Mailing Address - Country:US
Mailing Address - Phone:520-749-4430
Mailing Address - Fax:
Practice Address - Street 1:3900 N BEAR CANYON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-8220
Practice Address - Country:US
Practice Address - Phone:520-749-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist