Provider Demographics
NPI:1114040672
Name:KONRAD, SARA LYNN DOELGER (MA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN DOELGER
Last Name:KONRAD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 25TH AVE S
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4800
Mailing Address - Country:US
Mailing Address - Phone:320-252-0094
Mailing Address - Fax:320-252-0365
Practice Address - Street 1:606 25TH AVE S
Practice Address - Street 2:SUITE 107
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4800
Practice Address - Country:US
Practice Address - Phone:320-252-0094
Practice Address - Fax:320-252-0365
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist