Provider Demographics
NPI:1326451014
Name:GLACKEN, SARAH (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GLACKEN
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 1:10101 GROSVENOR PL
Mailing Address - Street 2:1713
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4668
Mailing Address - Country:US
Mailing Address - Phone:908-447-2241
Mailing Address - Fax:
Practice Address - Street 1:10101 GROSVENOR PL
Practice Address - Street 2:1713
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4668
Practice Address - Country:US
Practice Address - Phone:908-447-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0881L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist