Basic Information
| Provider Information | |||||||||
| NPI: | 1396233441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAGER | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | MARGARET | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8440 PIT STOP CT NW | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280278245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049601729 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8440 PIT STOP CT NW | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280278245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049601729 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2018 | ||||||||
| LastUpdateDate: | 03/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | IL | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 13647 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.