Provider Demographics
NPI:1740516160
Name:THAYER, SARAH ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:THAYER
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 1:809 LORENA RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4527
Mailing Address - Country:US
Mailing Address - Phone:813-598-3425
Mailing Address - Fax:
Practice Address - Street 1:5424 LAND O'LAKES BLVD.
Practice Address - Street 2:
Practice Address - City:LAND O' LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639
Practice Address - Country:US
Practice Address - Phone:813-335-1173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 4882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist