Provider Demographics
NPI:1457732174
Name:SHULTS, SARAH M (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:SHULTS
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 1:6767 S SPRUCE ST
Mailing Address - Street 2:ADAM'S CAMP
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1283
Mailing Address - Country:US
Mailing Address - Phone:303-563-8920
Mailing Address - Fax:
Practice Address - Street 1:6767 S SPRUCE ST
Practice Address - Street 2:ADAM'S CAMP
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1283
Practice Address - Country:US
Practice Address - Phone:303-563-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist