Provider Demographics
NPI:1639684897
Name:WARE, SARA KRIEGER (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:KRIEGER
Last Name:WARE
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 1:3186 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EXMORE
Mailing Address - State:VA
Mailing Address - Zip Code:23350
Mailing Address - Country:US
Mailing Address - Phone:757-442-5437
Mailing Address - Fax:
Practice Address - Street 1:3186 MAIN STREET
Practice Address - Street 2:
Practice Address - City:EXMORE
Practice Address - State:VA
Practice Address - Zip Code:23350
Practice Address - Country:US
Practice Address - Phone:757-442-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist