Provider Demographics
NPI:1194053454
Name:CULVER, SARA NICOLE
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:NICOLE
Last Name:CULVER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:NICOLE
Other - Last Name:DEVOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2705
Mailing Address - Country:US
Mailing Address - Phone:607-734-1861
Mailing Address - Fax:607-734-1985
Practice Address - Street 1:305 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2705
Practice Address - Country:US
Practice Address - Phone:607-734-1861
Practice Address - Fax:607-734-1985
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019239-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist