Provider Demographics
NPI:1366894503
Name:DENMAN, SARA (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DENMAN
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16554 BEAUREGARD DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-7571
Mailing Address - Country:US
Mailing Address - Phone:903-849-5013
Mailing Address - Fax:
Practice Address - Street 1:1001 WSW LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:N/A
Practice Address - Zip Code:75701
Practice Address - Country:UM
Practice Address - Phone:903-509-1313
Practice Address - Fax:903-509-1383
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist