Provider Demographics
NPI:1336419860
Name:YUBWANNIE, SANDRA ARTELIA (MA-SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ARTELIA
Last Name:YUBWANNIE
Suffix:
Gender:F
Credentials:MA-SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 STARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-4114
Mailing Address - Country:US
Mailing Address - Phone:919-724-7051
Mailing Address - Fax:919-471-3584
Practice Address - Street 1:2059 TORREDGE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-1767
Practice Address - Country:US
Practice Address - Phone:919-471-0781
Practice Address - Fax:919-620-0594
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist