Healthcare Provider Details

I. General information

NPI: 1154935187
Provider Name (Legal Business Name): SARA STAMER MS, CCC-SLP, TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4184 MILLER ST
WILLIAMSON NY
14589-9713
US

IV. Provider business mailing address

338 EAGLEHEAD RD
EAST ROCHESTER NY
14445-1608
US

V. Phone/Fax

Practice location:
  • Phone: 315-589-9661
  • Fax:
Mailing address:
  • Phone: 716-548-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number030927
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: