Provider Demographics
NPI:1508024506
Name:DAYMON, SARAH RAENEL 'NEL' (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RAENEL 'NEL'
Last Name:DAYMON
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 1:2409 CALICO LN
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-6871
Mailing Address - Country:US
Mailing Address - Phone:618-344-7395
Mailing Address - Fax:618-344-7395
Practice Address - Street 1:2409 CALICO LN
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-6871
Practice Address - Country:US
Practice Address - Phone:618-344-7395
Practice Address - Fax:618-344-7395
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146007663OtherSPEECH-LANGUAGE PATHOLOGIST