Provider Demographics
NPI:1477042422
Name:ALTMAN-KOPKO, SARAH MARIE (MA, MM, MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:ALTMAN-KOPKO
Suffix:
Gender:F
Credentials:MA, MM, MA CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:ALTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:928 HEDGEWYCK LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-1380
Mailing Address - Country:US
Mailing Address - Phone:740-350-8444
Mailing Address - Fax:
Practice Address - Street 1:928 HEDGEWYCK LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022
Practice Address - Country:US
Practice Address - Phone:740-350-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-05
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLO11687235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist