Provider Demographics
NPI:1427397405
Name:SOWYRDA, SARA (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:SOWYRDA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1874 MADISON ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3838
Mailing Address - Country:US
Mailing Address - Phone:718-496-0131
Mailing Address - Fax:
Practice Address - Street 1:1874 MADISON ST APT 3R
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3838
Practice Address - Country:US
Practice Address - Phone:718-496-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist