Provider Demographics
NPI:1942595046
Name:WEBER MCNULTY, SARAH KATHERINE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHERINE
Last Name:WEBER MCNULTY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KATHERINE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:104 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-1951
Mailing Address - Country:US
Mailing Address - Phone:732-610-0072
Mailing Address - Fax:
Practice Address - Street 1:104 MEADOWBROOK RD
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-1951
Practice Address - Country:US
Practice Address - Phone:732-610-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00615500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist