Provider Demographics
NPI:1659004877
Name:CONRAD, SARAH GRACE (AUD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:CONRAD
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 1:274 SAINT JOHNS PL APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5665
Mailing Address - Country:US
Mailing Address - Phone:656-660-1029
Mailing Address - Fax:
Practice Address - Street 1:8800 GLACIER HWY STE 116
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8079
Practice Address - Country:US
Practice Address - Phone:907-789-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK197198231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist