Provider Demographics
NPI:1720765365
Name:AUTREY, SARA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:AUTREY
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5226
Mailing Address - Country:US
Mailing Address - Phone:443-235-3989
Mailing Address - Fax:
Practice Address - Street 1:4155 E JEWELL AVE STE 900
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4513
Practice Address - Country:US
Practice Address - Phone:720-456-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0001116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist