Provider Demographics
NPI:1700488053
Name:SARAH VACHA SWALLOWING DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:SARAH VACHA SWALLOWING DIAGNOSTICS LLC
Other - Org Name:CARDINAL VOICE & SWALLOWING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VACHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-305-3050
Mailing Address - Street 1:792 JENNIFER TRL
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2977
Mailing Address - Country:US
Mailing Address - Phone:330-249-1212
Mailing Address - Fax:
Practice Address - Street 1:792 JENNIFER TRL
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2977
Practice Address - Country:US
Practice Address - Phone:330-249-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty