Provider Demographics
NPI:1659854180
Name:BURNS, SARAH JOY
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOY
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JOY
Other - Last Name:DIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6835 SALADIN AVE
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-3681
Mailing Address - Country:US
Mailing Address - Phone:716-517-0803
Mailing Address - Fax:
Practice Address - Street 1:5930 ADOBE RD
Practice Address - Street 2:
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277-2356
Practice Address - Country:US
Practice Address - Phone:760-367-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist