Provider Demographics
NPI:1598014839
Name:PAQUIN, SARAH JON (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH JON
Middle Name:
Last Name:PAQUIN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SARA JON
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3722 SHIPYARD BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6188
Mailing Address - Country:US
Mailing Address - Phone:910-343-8988
Mailing Address - Fax:910-343-4144
Practice Address - Street 1:3722 SHIPYARD BLVD
Practice Address - Street 2:STE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6188
Practice Address - Country:US
Practice Address - Phone:910-343-8988
Practice Address - Fax:910-343-4144
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10137235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist