Provider Demographics
NPI:1043601321
Name:MAENLE, SARAH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MAENLE
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 1:1200 RALSTON AVE
Mailing Address - Street 2:TOTAL REHAB
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-1396
Mailing Address - Country:US
Mailing Address - Phone:419-783-6943
Mailing Address - Fax:419-783-4421
Practice Address - Street 1:1200 RALSTON AVE
Practice Address - Street 2:TOTAL REHAB
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-1396
Practice Address - Country:US
Practice Address - Phone:419-783-6943
Practice Address - Fax:419-783-4421
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist