Provider Demographics
NPI:1710148804
Name:BEER, SARA L
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:BEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 LIEBIG SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:MASCOUTAH
Mailing Address - State:IL
Mailing Address - Zip Code:62258-4026
Mailing Address - Country:US
Mailing Address - Phone:618-201-1605
Mailing Address - Fax:
Practice Address - Street 1:6350 LIEBIG SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MASCOUTAH
Practice Address - State:IL
Practice Address - Zip Code:62258-4026
Practice Address - Country:US
Practice Address - Phone:618-201-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007815235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist