Provider Demographics
NPI:1609119825
Name:ALTIC, SARAH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:ALTIC
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 1:10241 KINGSTON PIKE STE 3
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3240
Mailing Address - Country:US
Mailing Address - Phone:865-409-1810
Mailing Address - Fax:844-364-1224
Practice Address - Street 1:10241 KINGSTON PIKE STE 3
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3240
Practice Address - Country:US
Practice Address - Phone:865-409-1810
Practice Address - Fax:844-364-1224
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist