Provider Demographics
NPI:1518251321
Name:BRADATEANU, SARAH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:BRADATEANU
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 SW 39TH DR APT B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4384
Mailing Address - Country:US
Mailing Address - Phone:352-215-3412
Mailing Address - Fax:
Practice Address - Street 1:2232 SW 39TH DR APT B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4384
Practice Address - Country:US
Practice Address - Phone:352-215-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist