Provider Demographics
NPI:1881268977
Name:STONE, SARA (MS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16899 N CORNWALLIS WAY
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-8257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2999 N LAKEHARBOR LN STE 202
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6291
Practice Address - Country:US
Practice Address - Phone:208-690-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2024-11-26
Deactivation Date:2021-06-02
Deactivation Code:
Reactivation Date:2021-08-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist