Provider Demographics
NPI:1033682422
Name:SPECIALE, SARAH ARDELLA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ARDELLA
Last Name:SPECIALE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E STROOP RD STE A
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2800
Mailing Address - Country:US
Mailing Address - Phone:937-304-6822
Mailing Address - Fax:937-381-6400
Practice Address - Street 1:301 E STROOP RD STE A
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2800
Practice Address - Country:US
Practice Address - Phone:937-304-6822
Practice Address - Fax:937-381-6400
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.020984225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist