Provider Demographics
NPI:1730273194
Name:FOLEY, SARA ANNA (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANNA
Last Name:FOLEY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 CEDAR DALE LN
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-8257
Mailing Address - Country:US
Mailing Address - Phone:417-443-0505
Mailing Address - Fax:
Practice Address - Street 1:2800 S FORT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-3480
Practice Address - Country:US
Practice Address - Phone:417-882-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist