Provider Demographics
NPI:1265073670
Name:GWINN, SARAH MICHELE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MICHELE
Last Name:GWINN
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 1:2532 LAS CASAS WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3420
Mailing Address - Country:US
Mailing Address - Phone:805-705-0503
Mailing Address - Fax:
Practice Address - Street 1:2532 LAS CASAS WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-3420
Practice Address - Country:US
Practice Address - Phone:805-705-0503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist