Provider Demographics
NPI:1699546721
Name:WEIGEL, SARA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WEIGEL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PRAIRIE HAWK DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8001
Mailing Address - Country:US
Mailing Address - Phone:303-387-0804
Mailing Address - Fax:
Practice Address - Street 1:9350 TEDDY LN
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2876
Practice Address - Country:US
Practice Address - Phone:303-387-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12030619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist