Individual
MISS SARA MARIE TYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
145 FOX DEN RD, BRISTOL, CT 06010
(860) 716-0715
Mailing address
1255 BENJAMIN DR, KENNETT SQUARE, PA 19348-1586
(610) 787-9465
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004476
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SL012158
SPEECH LANGUAGE PATHOLOGIST
PA
Enumeration date
05/02/2012
Last updated
11/22/2019
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