Provider Demographics
NPI:1285846956
Name:BEFUS, SANDRA MARIE (MA CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MARIE
Last Name:BEFUS
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:MARIE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 CONSETT CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-8336
Mailing Address - Country:US
Mailing Address - Phone:919-796-0918
Mailing Address - Fax:919-341-6912
Practice Address - Street 1:1520 CONSETT CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-8336
Practice Address - Country:US
Practice Address - Phone:919-796-0918
Practice Address - Fax:919-341-6912
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist