Provider Demographics
NPI:1417965625
Name:KLAJBOR, SARAH DRAKE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DRAKE
Last Name:KLAJBOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3958 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-4322
Mailing Address - Country:US
Mailing Address - Phone:414-698-3735
Mailing Address - Fax:414-456-6259
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3518
Practice Address - Country:US
Practice Address - Phone:414-266-5749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI472-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41150600Medicaid