Provider Demographics
NPI:1316376601
Name:KHALILIEH, SAHAR
Entity Type:Individual
Prefix:MISS
First Name:SAHAR
Middle Name:
Last Name:KHALILIEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 WARRENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1336
Mailing Address - Country:US
Mailing Address - Phone:740-369-9614
Mailing Address - Fax:740-363-5881
Practice Address - Street 1:2270 WARRENSBURG RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1336
Practice Address - Country:US
Practice Address - Phone:740-369-9614
Practice Address - Fax:740-363-5881
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist