Provider Demographics
NPI:1497154199
Name:NEVILLE, SARA EMILY (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:EMILY
Last Name:NEVILLE
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 1:1726 DAVENPORT DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4228
Mailing Address - Country:US
Mailing Address - Phone:727-493-2393
Mailing Address - Fax:
Practice Address - Street 1:1726 DAVENPORT DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4228
Practice Address - Country:US
Practice Address - Phone:727-493-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVP/SLP-0598235Z00000X
FLSA14573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist