Provider Demographics
NPI:1528369816
Name:JEWELL, SARAH E (MS SLP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:JEWELL
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 1/2 LOCKLIE ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7623
Mailing Address - Country:US
Mailing Address - Phone:727-692-2649
Mailing Address - Fax:
Practice Address - Street 1:3110 75TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-2326
Practice Address - Country:US
Practice Address - Phone:727-343-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist