Provider Demographics
NPI:1225695315
Name:WEBER, SARAH E (MSSLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:WEBER
Suffix:
Gender:F
Credentials:MSSLP-CCC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:TYNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2790 N ACADEMY BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5337
Mailing Address - Country:US
Mailing Address - Phone:719-425-7771
Mailing Address - Fax:719-208-7730
Practice Address - Street 1:2790 N ACADEMY BLVD STE 235
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5337
Practice Address - Country:US
Practice Address - Phone:719-425-7771
Practice Address - Fax:719-208-7730
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0003596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist