Healthcare Provider Details

I. General information

NPI: 1750214599
Provider Name (Legal Business Name): SARAH EMMALINE TALLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4600 LAKE BOONE TRL STE 100
RALEIGH NC
27607-7529
US

IV. Provider business mailing address

115 WESTVIEW COVE LN
CARY NC
27513-4963
US

V. Phone/Fax

Practice location:
  • Phone: 919-420-2029
  • Fax:
Mailing address:
  • Phone: 828-421-8298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30005152
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: