Provider Demographics
NPI:1063020899
Name:CARMICHAEL, SARA WILLIS (SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:WILLIS
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-3023
Mailing Address - Country:US
Mailing Address - Phone:603-692-4411
Mailing Address - Fax:603-692-6717
Practice Address - Street 1:806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2603
Practice Address - Country:US
Practice Address - Phone:603-524-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2126235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist