Provider Demographics
NPI:1831452275
Name:CONRAD, SARA A (AUD)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:A
Last Name:CONRAD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17577 NASSAU COMMONS BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6288
Mailing Address - Country:US
Mailing Address - Phone:302-645-7603
Mailing Address - Fax:302-645-7604
Practice Address - Street 1:17577 NASSAU COMMONS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6288
Practice Address - Country:US
Practice Address - Phone:302-645-7603
Practice Address - Fax:302-645-7604
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001490237600000X
DEO2-0000231237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter