Provider Demographics
NPI:1699022939
Name:SAWYER, SARA (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 MOTT STREET
Mailing Address - Street 2:APT 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:917-572-3186
Mailing Address - Fax:
Practice Address - Street 1:284 MOTT ST
Practice Address - Street 2:APT 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3471
Practice Address - Country:US
Practice Address - Phone:917-572-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021753235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist