Provider Demographics
NPI:1386873479
Name:ALLEN, SARAH P (EDS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:P
Last Name:ALLEN
Suffix:
Gender:F
Credentials:EDS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 HUNTINGTON PL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-7091
Mailing Address - Country:US
Mailing Address - Phone:706-766-6635
Mailing Address - Fax:
Practice Address - Street 1:507 HUNTINGTON PL
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-7091
Practice Address - Country:US
Practice Address - Phone:706-766-6635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007836235Z00000X
AL2924235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist