1528587649 NPI number — SARAH STEVENSON MS, SLP

Table of content: SARAH STEVENSON MS, SLP (NPI 1528587649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528587649 NPI number — SARAH STEVENSON MS, SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEVENSON
Provider First Name:
SARAH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEVENSON
Provider Other First Name:
SARAH
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, SLP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528587649
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4265 SPRING DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89502-5909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-636-2878
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 HAMMILL LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89511-1004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-828-5600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SP-2120 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SP-2120 . This is a "SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSIGN BOARD (STATE OF NV" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".