Basic Information
Provider Information
NPI: 1073098885
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRIGGS
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 606 WISCONSIN AVE
Address2:  
City: WHITEFISH
State: MT
PostalCode: 599372128
CountryCode: US
TelephoneNumber: 7758303941
FaxNumber:  
Practice Location
Address1: 1305 7TH ST
Address2:  
City: WHITEFISH
State: MT
PostalCode: 599372850
CountryCode: US
TelephoneNumber: 4068623557
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/27/2018
LastUpdateDate: 09/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSLP-SC-LIC-7361MTY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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