Provider Demographics
NPI:1184089450
Name:JAMES, SARA SWAN (M ED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:SWAN
Last Name:JAMES
Suffix:
Gender:F
Credentials:M ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4405 EVANS TO LOCKS RD STE C
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3603
Mailing Address - Country:US
Mailing Address - Phone:706-854-1598
Mailing Address - Fax:706-854-8136
Practice Address - Street 1:4405 EVANS TO LOCKS RD STE C
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3603
Practice Address - Country:US
Practice Address - Phone:706-854-1598
Practice Address - Fax:706-854-8136
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002295235Z00000X
GASLP009516235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist