Provider Demographics
NPI:1821421306
Name:TOWNE, SARA NICOLE
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:NICOLE
Last Name:TOWNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:NICOLE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1840 NENA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-3782
Mailing Address - Country:US
Mailing Address - Phone:850-559-1068
Mailing Address - Fax:
Practice Address - Street 1:2888 MAHAN DR STE 7&8
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5464
Practice Address - Country:US
Practice Address - Phone:850-727-7928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 13013235Z00000X
FLSI 22512355S0801X
FLSZ 6377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant