Provider Demographics
NPI:1922668557
Name:POLIGONE, SARAH SPICELAND (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SPICELAND
Last Name:POLIGONE
Suffix:
Gender:F
Credentials:MS, 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:VANDERBILT BILL WILKERSON CENTER, MCE, SOUTH TOWER
Mailing Address - Street 2:1215 21ST AVENUE SOUTH, SUITE 6209
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-8718
Mailing Address - Country:US
Mailing Address - Phone:615-936-5000
Mailing Address - Fax:
Practice Address - Street 1:VANDERBILT BILL WILKERSON CENTER, MCE, SOUTH TOWER
Practice Address - Street 2:1215 21ST AVENUE SOUTH, SUITE 6209
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8718
Practice Address - Country:US
Practice Address - Phone:615-936-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist