Provider Demographics
NPI:1265767560
Name:TREMBLAY, SARAH MARIE (MS)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:MARIE
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 COMMONWEALTH AVE
Mailing Address - Street 2:APT BF
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2123
Mailing Address - Country:US
Mailing Address - Phone:617-650-0333
Mailing Address - Fax:
Practice Address - Street 1:346 COMMONWEALTH AVE
Practice Address - Street 2:APT BF
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2123
Practice Address - Country:US
Practice Address - Phone:617-650-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist