Healthcare Provider Details

I. General information

NPI: 1154597912
Provider Name (Legal Business Name): SARA LANGSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20900 ROLAND HEIGHTS RD
ROLAND AR
72135-9685
US

IV. Provider business mailing address

20900 ROLAND HEIGHTS RD
ROLAND AR
72135-9685
US

V. Phone/Fax

Practice location:
  • Phone: 501-868-4740
  • Fax: 501-868-6498
Mailing address:
  • Phone: 501-868-4740
  • Fax: 501-868-6498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: