Provider Demographics
NPI:1013426055
Name:WOODARD, SARAH ELIZABETH GILBERG
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH GILBERG
Last Name:WOODARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH GILBERG
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:574 N 24TH ST APT 7B
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-5623
Mailing Address - Country:US
Mailing Address - Phone:603-856-4870
Mailing Address - Fax:
Practice Address - Street 1:810 BELLA VISTA RD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4640
Practice Address - Country:US
Practice Address - Phone:479-254-5873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist