Provider Demographics
NPI:1487188009
Name:LAAKSO, SARAH MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:LAAKSO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9570
Mailing Address - Country:US
Mailing Address - Phone:413-584-1818
Mailing Address - Fax:413-584-1866
Practice Address - Street 1:104 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9570
Practice Address - Country:US
Practice Address - Phone:413-584-1866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA817231H00000X
CT17.000593237600000X, 231H00000X
MA4697237600000X, 231H00000X
MA237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400409307OtherMEDICARE