Provider Demographics
NPI:1477598324
Name:WYGAL, SARA CHRISTY (SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:CHRISTY
Last Name:WYGAL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 KINGS MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2520
Mailing Address - Country:US
Mailing Address - Phone:501-228-6071
Mailing Address - Fax:
Practice Address - Street 1:1007 KINGS MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2520
Practice Address - Country:US
Practice Address - Phone:501-228-6071
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist