Provider Demographics
NPI:1639238025
Name:GEORGE, SARA (MA CFY-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MA CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 W MCDOWELL RD APT 2108
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-4817
Mailing Address - Country:US
Mailing Address - Phone:623-936-6928
Mailing Address - Fax:
Practice Address - Street 1:10150 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-4322
Practice Address - Country:US
Practice Address - Phone:623-772-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist