Provider Demographics
NPI:1962642546
Name:MILHOLLAND, SARAH JOHNSON (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JOHNSON
Last Name:MILHOLLAND
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 1:185 CHARLOIS BLVD
Mailing Address - Street 2:SPEECHCENTER
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103
Mailing Address - Country:US
Mailing Address - Phone:336-725-0222
Mailing Address - Fax:336-725-0454
Practice Address - Street 1:185 CHARLOIS BLVD
Practice Address - Street 2:SPEECHCENTER
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-725-0222
Practice Address - Fax:336-725-0454
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NC7651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1533COtherBLUE CROSS BLUE SHIELD
NC7413164Medicaid