Provider Demographics
NPI:1225560493
Name:GARGOTTO, SARAH MARGARET (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:MARGARET
Last Name:GARGOTTO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:3133 N RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1473
Mailing Address - Country:US
Mailing Address - Phone:518-821-2422
Mailing Address - Fax:
Practice Address - Street 1:5699 W 20TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2915
Practice Address - Country:US
Practice Address - Phone:970-451-1234
Practice Address - Fax:970-284-7892
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026097235Z00000X
MA9979235Z00000X
CO0002770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1225560493Medicaid