Provider Demographics
NPI:1942745435
Name:HOSMER, SABRINA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:HOSMER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:JARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:143 FERN RD
Mailing Address - Street 2:
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2750
Mailing Address - Country:US
Mailing Address - Phone:860-550-2059
Mailing Address - Fax:
Practice Address - Street 1:143 FERN RD
Practice Address - Street 2:
Practice Address - City:STORRS MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06268-2750
Practice Address - Country:US
Practice Address - Phone:860-550-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT18.004543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist