Healthcare Provider Details

I. General information

NPI: 1649019746
Provider Name (Legal Business Name): SARAH BARRETT MCCOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 CHESTNUT ST
NEWTON MA
02465-2550
US

IV. Provider business mailing address

89 STRATHMORE RD APT 21
BRIGHTON MA
02135-7114
US

V. Phone/Fax

Practice location:
  • Phone: 978-237-4937
  • Fax:
Mailing address:
  • Phone: 857-540-2136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9757
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: