Provider Demographics
NPI:1609269224
Name:LOCKHART, SARAH (SLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 SISKIYOU BLVD
Mailing Address - Street 2:SUITE 266
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2336
Mailing Address - Country:US
Mailing Address - Phone:541-708-3940
Mailing Address - Fax:844-234-5619
Practice Address - Street 1:1467 SISKIYOU BLVD
Practice Address - Street 2:SUITE 266
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2336
Practice Address - Country:US
Practice Address - Phone:541-708-3940
Practice Address - Fax:844-234-5619
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist