Provider Demographics
NPI:1194394742
Name:ROSS, SARA STEVENS (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:STEVENS
Last Name:ROSS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1874
Mailing Address - Country:US
Mailing Address - Phone:270-313-5350
Mailing Address - Fax:
Practice Address - Street 1:1050 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1874
Practice Address - Country:US
Practice Address - Phone:270-313-5350
Practice Address - Fax:502-596-1422
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist