Provider Demographics
NPI:1467265819
Name:CASTORO, SARAH MICHELLE (MED CF-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:CASTORO
Suffix:
Gender:F
Credentials:MED CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 ABUTMENT RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-4680
Mailing Address - Country:US
Mailing Address - Phone:706-252-8660
Mailing Address - Fax:706-841-9211
Practice Address - Street 1:1011 ABUTMENT RD STE 112
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-4660
Practice Address - Country:US
Practice Address - Phone:706-252-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET004164235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPCET004164OtherPCE STATE LICENSE FOR SPEECH PATHOLOGY