Provider Demographics
NPI:1851557219
Name:LITMER, SARA MAE (MSCCC-SLP, BCABA)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:MAE
Last Name:LITMER
Suffix:
Gender:F
Credentials:MSCCC-SLP, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 TOUBY PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-2573
Mailing Address - Country:US
Mailing Address - Phone:765-628-7400
Mailing Address - Fax:765-450-6453
Practice Address - Street 1:1314 N LIBERTY CIR E
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-6647
Practice Address - Country:US
Practice Address - Phone:812-663-2273
Practice Address - Fax:812-663-2275
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0-18-9395106E00000X
IN22004689A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300017213Medicaid