Provider Demographics
NPI:1366935025
Name:SPIVEY, SARA LYNNE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LYNNE
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 AVERYS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9479
Mailing Address - Country:US
Mailing Address - Phone:904-923-6058
Mailing Address - Fax:
Practice Address - Street 1:2 WALDEN RIDGE DR STE 20A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8598
Practice Address - Country:US
Practice Address - Phone:828-274-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist