Provider Demographics
NPI:1326413139
Name:BENT, SARAH M
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:BENT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SARAH LONG
Other - Middle Name:M
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CF-SLP
Mailing Address - Street 1:3498 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RESCUE
Mailing Address - State:CA
Mailing Address - Zip Code:95672-9625
Mailing Address - Country:US
Mailing Address - Phone:530-391-8670
Mailing Address - Fax:
Practice Address - Street 1:3498 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:RESCUE
Practice Address - State:CA
Practice Address - Zip Code:95672-9625
Practice Address - Country:US
Practice Address - Phone:530-391-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist