Individual
MS. SARAH STORK TATKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
275 ROUTE 30 N, BOMOSEEN, VT 05732-9647
(802) 468-5641
(802) 468-2923
Mailing address
71 ALLEN ST, STE 101, RUTLAND, VT 05701-4570
(800) 468-9118
(802) 772-7973
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
8053008
VT
363AM0700X
Medical Physician Assistant
Primary
055.0031204
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000662
—
VT
Enumeration date
04/20/2009
Last updated
04/01/2021
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