Provider Demographics
NPI:1073780201
Name:HALL, SARAH MARIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:HALL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 W SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-9666
Mailing Address - Country:US
Mailing Address - Phone:716-679-6011
Mailing Address - Fax:716-672-7801
Practice Address - Street 1:5109 W SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-9666
Practice Address - Country:US
Practice Address - Phone:716-679-6011
Practice Address - Fax:716-672-7801
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist