MEDICARE: SARAH D FOLSOM 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
1	224Z00000X	Occupational Therapy Assistant	1003550	NC
2	235Z00000X	Speech-Language Pathologist	1124	NC
3	235Z00000X	Speech-Language Pathologist	2202004090	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	32913	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1962454496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH D FOLSOM CCC-SLP

Provider Business Mailing Address
First Line	:	22 ARROWWOOD CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27712-8966
Country	:	US
Telephone Number	:	919-870-5140
Fax Number	:	888-282-8635

Provider Business Practice Location Address
First Line	:	22 ARROWWOOD CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27712-8966
Country	:	US
Telephone Number	:	919-870-5140
Fax Number	:	888-282-8635

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	05/27/2022

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Directions to “ SARAH D FOLSOM CCC-SLP” Practice Location

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