Provider Demographics
NPI:1528207891
Name:BUNTING, SARA LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:BUNTING
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 1:16 W 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2119
Mailing Address - Country:US
Mailing Address - Phone:775-721-4524
Mailing Address - Fax:
Practice Address - Street 1:2606 E SNEAD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-9587
Practice Address - Country:US
Practice Address - Phone:509-209-7429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60031542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist