Provider Demographics
NPI:1982316170
Name:GOODMAN, SARA
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6903 MAKERS WAY
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-1755
Mailing Address - Country:US
Mailing Address - Phone:813-431-6176
Mailing Address - Fax:
Practice Address - Street 1:6903 MAKERS WAY
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1755
Practice Address - Country:US
Practice Address - Phone:813-431-6176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant