Provider Demographics
NPI:1740453729
Name:RODGERS, SARAH RENEE (SLP)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:RENEE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CARTWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:CHICORA
Mailing Address - State:PA
Mailing Address - Zip Code:16025-4208
Mailing Address - Country:US
Mailing Address - Phone:724-445-1186
Mailing Address - Fax:
Practice Address - Street 1:142 CARTWRIGHT RD
Practice Address - Street 2:
Practice Address - City:CHICORA
Practice Address - State:PA
Practice Address - Zip Code:16025-4208
Practice Address - Country:US
Practice Address - Phone:724-445-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist