Provider Demographics
NPI:1730559725
Name:DAVISON, SARAH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:DAVISON
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 1:1040 WHALLEY AVE
Mailing Address - Street 2:CHAPEL HAVEN - ASAT PROGRAM
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1740
Mailing Address - Country:US
Mailing Address - Phone:203-397-1714
Mailing Address - Fax:203-389-0422
Practice Address - Street 1:1040 WHALLEY AVE
Practice Address - Street 2:CHAPEL HAVEN - ASAT PROGRAM
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1740
Practice Address - Country:US
Practice Address - Phone:203-397-1714
Practice Address - Fax:203-389-0422
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist