Provider Demographics
NPI:1831359199
Name:BALDWIN, SARAH MCALLISTER (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MCALLISTER
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30422 FOREST PARKE DR
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8102
Mailing Address - Country:US
Mailing Address - Phone:904-271-5364
Mailing Address - Fax:
Practice Address - Street 1:30422 FOREST PARKE DR
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-8102
Practice Address - Country:US
Practice Address - Phone:904-271-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7013235Z00000X
NC10864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist