Provider Demographics
NPI:1023035052
Name:MASTROPOLE, SARA KATHRYN (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:KATHRYN
Last Name:MASTROPOLE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S EADS ST
Mailing Address - Street 2:APT #830
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-3027
Mailing Address - Country:US
Mailing Address - Phone:703-966-5458
Mailing Address - Fax:
Practice Address - Street 1:1900 S EADS ST
Practice Address - Street 2:APT #830
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3027
Practice Address - Country:US
Practice Address - Phone:703-966-5458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004734235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist