Provider Demographics
NPI:1942686076
Name:MULHEARN, SARA ASHLEY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ASHLEY
Last Name:MULHEARN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ASHLEY
Other - Last Name:MCMAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:675 WILLOW VALLEY SQ
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4876
Mailing Address - Country:US
Mailing Address - Phone:717-464-7645
Mailing Address - Fax:717-464-6017
Practice Address - Street 1:900 WILLOW VALLEY LAKES DR
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9051
Practice Address - Country:US
Practice Address - Phone:717-464-6861
Practice Address - Fax:717-464-8444
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011953235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396818Medicare Oscar/Certification