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General NPI Number Information
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NPI Number | 1275300683
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Entity Type | Individual
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Provider Name | SARAH BRUNO MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 107 WILCOX RD STE 107C
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City | STONINGTON
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State | CT
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Zip | 06378-2614
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Country | US
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Telephone | 860-271-5041
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Fax |
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Provider Business Mailing Address
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Address Line | 300 HALEY RD
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City | MYSTIC
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State | CT
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Zip | 06355-1059
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Country | US
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Telephone | 860-271-5041
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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 | 004182
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License Number State | CT
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