Provider Demographics
NPI:1679877732
Name:HITNER, SARA B (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:B
Last Name:HITNER
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 1:259 YORK ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3954
Mailing Address - Country:US
Mailing Address - Phone:917-754-1327
Mailing Address - Fax:
Practice Address - Street 1:912 LONG PLAINS RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-3208
Practice Address - Country:US
Practice Address - Phone:207-929-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2039235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist