Provider Demographics
NPI:1871371351
Name:DEAN, SARAH TOY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:TOY
Last Name:DEAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:DIANTHA
Other - Last Name:TOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3820 E 180 N
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-5775
Mailing Address - Country:US
Mailing Address - Phone:208-680-6489
Mailing Address - Fax:
Practice Address - Street 1:3820 E 180 N
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-5775
Practice Address - Country:US
Practice Address - Phone:208-680-6489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist