Provider Demographics
NPI:1043427677
Name:MUCENSKI, SARAH MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MARIE
Last Name:MUCENSKI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:HELFRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:664 BREESPORT N CHEMUNG RD
Mailing Address - Street 2:
Mailing Address - City:LOWMAN
Mailing Address - State:NY
Mailing Address - Zip Code:14861-8960
Mailing Address - Country:US
Mailing Address - Phone:607-734-3965
Mailing Address - Fax:
Practice Address - Street 1:602 IVY ST
Practice Address - Street 2:REHABILITATION SERVICES
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1646
Practice Address - Country:US
Practice Address - Phone:607-737-4131
Practice Address - Fax:607-735-5710
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014366-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist