Provider Demographics
NPI:1336373752
Name:MCDONNELL, SARAH JANE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1700 12TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9540
Mailing Address - Country:US
Mailing Address - Phone:416-450-1145
Mailing Address - Fax:541-436-3570
Practice Address - Street 1:1700 12TH ST STE C
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9540
Practice Address - Country:US
Practice Address - Phone:541-645-0114
Practice Address - Fax:541-436-3570
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017653-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist