Provider Demographics
NPI:1457504169
Name:DEVOE, SANDRA LYNN (MSCCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNN
Last Name:DEVOE
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 MOLASSES HILL RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NY
Mailing Address - Zip Code:14005-9757
Mailing Address - Country:US
Mailing Address - Phone:585-343-5158
Mailing Address - Fax:
Practice Address - Street 1:10725 MOLASSES HILL RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NY
Practice Address - Zip Code:14005-9757
Practice Address - Country:US
Practice Address - Phone:585-343-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006210-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist