Provider Demographics
NPI:1063180206
Name:VALLI, SARA JANE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:VALLI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:KATHLEEN
Other - Last Name:VALLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:122 NH ROUTE 12A UNIT 5
Mailing Address - Street 2:
Mailing Address - City:LANGDON
Mailing Address - State:NH
Mailing Address - Zip Code:03602-8263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 NH ROUTE 12A UNIT 5
Practice Address - Street 2:
Practice Address - City:LANGDON
Practice Address - State:NH
Practice Address - Zip Code:03602-8263
Practice Address - Country:US
Practice Address - Phone:603-835-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist