Provider Demographics
NPI:1093195299
Name:ARCHETTI, SARA ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELIZABETH
Last Name:ARCHETTI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:KRUKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:174 TROUT LILY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKE FREDRICK
Mailing Address - State:VA
Mailing Address - Zip Code:22630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FREDERICK COUNTY PUBLIC SCHOOLS
Practice Address - Street 2:1415 AMHERST STREET
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-662-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007027235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist