MEDICARE: MRS. SARA NICOLE TOWNE

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
1	235Z00000X	Speech-Language Pathologist	SA 13013	FL
2	2355S0801X	Speech-Language Assistant	SI 2251	FL
3	235Z00000X	Speech-Language Pathologist	SZ 6377	FL

General Provider Information

NPI Number	:	1821421306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA NICOLE TOWNE

Provider Business Mailing Address
First Line	:	1840 NENA HILLS DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-3782
Country	:	US
Telephone Number	:	850-559-1068
Fax Number	:

Provider Business Practice Location Address
First Line	:	2888 MAHAN DR STE 7&8
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5464
Country	:	US
Telephone Number	:	850-727-7928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	06/16/2014

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