Provider Demographics
NPI:1710403696
Name:HALL, SARAH MARIE (MA,CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HALL
Suffix:
Gender:F
Credentials:MA,CF-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:GRZYBOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1609 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1806
Mailing Address - Country:US
Mailing Address - Phone:419-671-3200
Mailing Address - Fax:
Practice Address - Street 1:2620 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4322
Practice Address - Country:US
Practice Address - Phone:419-671-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2017312235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty