Provider Demographics
NPI:1073663159
Name:BARTSCH, SARAH GAMILA HASAN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:GAMILA HASAN
Last Name:BARTSCH
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 1:1289 OLIVER ST
Mailing Address - Street 2:PEDIATRIC DEVELOPMENTAL THERAPY
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4450
Mailing Address - Country:US
Mailing Address - Phone:910-483-8331
Mailing Address - Fax:
Practice Address - Street 1:1289 OLIVER ST
Practice Address - Street 2:PEDIATRIC DEVELOPMENTAL THERAPY
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4450
Practice Address - Country:US
Practice Address - Phone:910-483-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ3925235Z00000X
NC10133235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL355246OtherWELLCARE
FL891241600Medicaid