Provider Demographics
NPI:1962825422
Name:SABO, THOMAS EDWARD (SLP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:SABO
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5897 WINCHELL RD
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:OH
Mailing Address - Zip Code:44234-9785
Mailing Address - Country:US
Mailing Address - Phone:330-388-8497
Mailing Address - Fax:
Practice Address - Street 1:5897 WINCHELL RD
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:OH
Practice Address - Zip Code:44234-9785
Practice Address - Country:US
Practice Address - Phone:330-388-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 12527235Z00000X, 314000000X
OHSP 5816235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility