Provider Demographics
NPI:1689762247
Name:DECK, SARA MORIARTY (MS ED, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MORIARTY
Last Name:DECK
Suffix:
Gender:F
Credentials:MS ED, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LANCASTER LANE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127
Mailing Address - Country:US
Mailing Address - Phone:716-662-2744
Mailing Address - Fax:
Practice Address - Street 1:4 LANCASTER LN
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2852
Practice Address - Country:US
Practice Address - Phone:716-662-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010787-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist