Provider Demographics
NPI:1316643414
Name:OWEN, SARAH (CF-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BLAINE DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-7373
Mailing Address - Country:US
Mailing Address - Phone:719-650-4713
Mailing Address - Fax:
Practice Address - Street 1:311 N CLYDE MORRIS BLVD STE 50
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2701
Practice Address - Country:US
Practice Address - Phone:386-425-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10599235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist