Provider Demographics
NPI:1477758373
Name:SABO, DENISE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SABO
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CLEEK DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-8605
Mailing Address - Country:US
Mailing Address - Phone:336-616-0946
Mailing Address - Fax:
Practice Address - Street 1:240 CLEEK DR
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-8605
Practice Address - Country:US
Practice Address - Phone:336-616-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6156OtherSPEECH PATHOLOGY LICENSE