Provider Demographics
NPI:1437436763
Name:DEVITO, SARA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:DEVITO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2507
Mailing Address - Country:US
Mailing Address - Phone:973-239-1533
Mailing Address - Fax:
Practice Address - Street 1:81 ELMWOOD RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2507
Practice Address - Country:US
Practice Address - Phone:973-239-1533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist