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General NPI Number Information
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NPI Number | 1124282173
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Entity Type | Individual
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Provider Name | SAMANTHA A SAWYER M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 1111 ELWAY ST APT 504
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City | SAINT PAUL
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State | MN
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Zip | 55116-3236
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Country | US
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Telephone | 651-785-3059
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 ELWAY ST APT 504
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City | SAINT PAUL
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State | MN
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Zip | 55116-3236
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Country | US
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Telephone | 651-785-3059
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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 | 8366
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License Number State | MN
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