Provider Demographics
NPI:1073851937
Name:PORTER, SARAH KATHERINE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:KATHERINE
Last Name:PORTER
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 1:193 PORTER SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-3044
Mailing Address - Country:US
Mailing Address - Phone:207-329-0744
Mailing Address - Fax:
Practice Address - Street 1:193 PORTER SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-3044
Practice Address - Country:US
Practice Address - Phone:207-329-0744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-27
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP3290235Z00000X
FLSA10042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist