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General NPI Number Information
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NPI Number | 1114277076
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Entity Type | Individual
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Provider Name | SARAH KINDERVATER SLP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 1488 BELK BLVD
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City | OXFORD
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State | MS
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Zip | 38655-5356
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Country | US
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Telephone | 662-855-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 711 AVIGNON DR
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City | RIDGELAND
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State | MS
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Zip | 39157-5120
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Country | US
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Telephone | 601-605-6777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA11835
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S4523
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License Number State | MS
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