Provider Demographics
NPI:1528587649
Name:STEVENSON, SARAH (MS, SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:4265 SPRING DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5909
Mailing Address - Country:US
Mailing Address - Phone:775-636-2878
Mailing Address - Fax:
Practice Address - Street 1:555 HAMMILL LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1004
Practice Address - Country:US
Practice Address - Phone:775-828-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVSP-2120OtherSPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSIGN BOARD (STATE OF NV