Provider Demographics
NPI:1659569721
Name:SAWYER, JUDITH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8414 W MEADOW PASS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1670
Mailing Address - Country:US
Mailing Address - Phone:316-304-4964
Mailing Address - Fax:
Practice Address - Street 1:8414 W MEADOW PASS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1670
Practice Address - Country:US
Practice Address - Phone:316-304-4964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-13
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000115877OtherBCBSKS