Provider Demographics
NPI:1447869557
Name:SHARPE, SARAH JANE (MS, SLP-CCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E 8TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3316
Mailing Address - Country:US
Mailing Address - Phone:865-696-7581
Mailing Address - Fax:
Practice Address - Street 1:6215 STONE RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4847
Practice Address - Country:US
Practice Address - Phone:727-605-3060
Practice Address - Fax:727-645-5215
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP009200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist