Healthcare Provider Details

I. General information

NPI: 1356800544
Provider Name (Legal Business Name): SARAH BYERLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 PROVIDENCE RD STE B
CHARLOTTE NC
28207-2678
US

IV. Provider business mailing address

1037 PROVIDENCE RD STE B
CHARLOTTE NC
28207-2678
US

V. Phone/Fax

Practice location:
  • Phone: 704-266-0886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL018299
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-1370
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14132
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: