Provider Demographics
NPI:1740608025
Name:ARELLANO, SARA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:HOLMAN
Mailing Address - State:NM
Mailing Address - Zip Code:87723-0256
Mailing Address - Country:US
Mailing Address - Phone:505-690-0634
Mailing Address - Fax:
Practice Address - Street 1:305 DON FERNANDO ST
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5954
Practice Address - Country:US
Practice Address - Phone:505-690-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-5489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist