Provider Demographics
NPI:1538550215
Name:SARRAZIN, COLLEEN MEGHAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MEGHAN
Last Name:SARRAZIN
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 1:12712 MACHIAVELLI WAY
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6232
Mailing Address - Country:US
Mailing Address - Phone:301-742-2555
Mailing Address - Fax:
Practice Address - Street 1:12712 MACHIAVELLI WAY
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6232
Practice Address - Country:US
Practice Address - Phone:301-742-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA19519235Z00000X
IL242.003365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist