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NPI Code Detail

MEDICARE: MRS. SARA MICHELLE HERON-VANTA M.A. CCC-SLP

MEDICARE:  MRS. SARA MICHELLE HERON-VANTA  M.A. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 8349FL

General Provider Information

NPI Number : 1760422125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARA MICHELLE HERON-VANTA M.A. CCC-SLP
Provider Business Mailing Address
First Line : 103 WINTERGLEN DR
Second Line :
City : SANFORD
State : FL
Zip : 32771-3688
Country : US
Telephone Number : 407-547-6721
Fax Number :
Provider Business Practice Location Address
First Line : 911 N SPRING GARDEN AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-2560
Country : US
Telephone Number : 386-736-3108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. SARA MICHELLE HERON-VANTA M.A. CCC-SLP” Practice Location

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