Provider Demographics
NPI:1265636005
Name:VERGARA-PLANTS, SANDRA M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:VERGARA-PLANTS
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 1:4301 CLIFTON DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-5667
Mailing Address - Country:US
Mailing Address - Phone:910-261-9127
Mailing Address - Fax:910-485-6315
Practice Address - Street 1:519 BEAUMONT RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4424
Practice Address - Country:US
Practice Address - Phone:910-257-2005
Practice Address - Fax:910-485-6315
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist