Provider Demographics
NPI:1801443205
Name:GLOWAZEWSKI, SARAH JANE (CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:GLOWAZEWSKI
Suffix:
Gender:F
Credentials:CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 PROCTOR RD
Mailing Address - Street 2:
Mailing Address - City:GLEN SPEY
Mailing Address - State:NY
Mailing Address - Zip Code:12737-5574
Mailing Address - Country:US
Mailing Address - Phone:845-456-1100
Mailing Address - Fax:
Practice Address - Street 1:1045 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:GLEN SPEY
Practice Address - State:NY
Practice Address - Zip Code:12737-5574
Practice Address - Country:US
Practice Address - Phone:845-456-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030236235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist