Provider Demographics
NPI:1104587807
Name:MONTANDON, SARAH BETH (MS SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:MONTANDON
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:B
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1032 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH AFB
Mailing Address - State:SD
Mailing Address - Zip Code:57706-4202
Mailing Address - Country:US
Mailing Address - Phone:325-320-4788
Mailing Address - Fax:
Practice Address - Street 1:1032 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:ELLSWORTH AFB
Practice Address - State:SD
Practice Address - Zip Code:57706-4202
Practice Address - Country:US
Practice Address - Phone:325-320-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1035-PROV235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist