Healthcare Provider Details

I. General information

NPI: 1669783445
Provider Name (Legal Business Name): SARAH YEAMANS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 FALLSTAFF RD APT A
BALTIMORE MD
21209-2911
US

IV. Provider business mailing address

3012 FALLSTAFF RD APT A
BALTIMORE MD
21209-2911
US

V. Phone/Fax

Practice location:
  • Phone: 410-764-3616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number06080
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: