Provider Demographics
NPI:1235458969
Name:HARVEY, SARA SIMPSON (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:SIMPSON
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 TIMBER CREEK DR # 101
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4234
Mailing Address - Country:US
Mailing Address - Phone:901-309-5219
Mailing Address - Fax:
Practice Address - Street 1:146 TIMBER CREEK DR # 101
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4234
Practice Address - Country:US
Practice Address - Phone:901-309-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12151922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist