Provider Demographics
NPI:1871033027
Name:KING, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KING
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 1:815 FROST RD
Mailing Address - Street 2:#2208
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4731
Mailing Address - Country:US
Mailing Address - Phone:717-451-6767
Mailing Address - Fax:
Practice Address - Street 1:815 FROST RD
Practice Address - Street 2:#2208
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4731
Practice Address - Country:US
Practice Address - Phone:717-451-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2017063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist