Provider Demographics
NPI:1548349319
Name:REAVES, SARAH JANE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:REAVES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:272 N ODELL ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2121
Mailing Address - Country:US
Mailing Address - Phone:317-408-0644
Mailing Address - Fax:317-858-9780
Practice Address - Street 1:1060 E 86TH ST
Practice Address - Street 2:SUITE 65C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1863
Practice Address - Country:US
Practice Address - Phone:317-566-8260
Practice Address - Fax:317-566-8270
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003471A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist