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General NPI Number Information
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NPI Number | 1649982513
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Entity Type | Individual
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Provider Name | SARA D W LYNCH MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 114 QUAIL HOLLOW RD
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City | FELTON
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State | CA
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Zip | 95018-9452
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Country | US
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Telephone | 831-359-8446
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 WOODSTOCK DR
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1657
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Country | US
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Telephone | 831-359-8446
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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 | SP17977
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License Number State | CA
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