Provider Demographics
NPI:1629394499
Name:BELL-INGRAHAM, SARAH M (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:BELL-INGRAHAM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:926 CORCORAN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4221
Mailing Address - Country:US
Mailing Address - Phone:831-239-6454
Mailing Address - Fax:
Practice Address - Street 1:926 CORCORAN AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4221
Practice Address - Country:US
Practice Address - Phone:831-239-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18827235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist