Provider Demographics
NPI:1982995429
Name:GILBERT, SARAH ROSE (MS CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ROSE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP/L
Mailing Address - Street 1:140 SOUTHWESTERN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-2117
Mailing Address - Country:US
Mailing Address - Phone:716-338-0668
Mailing Address - Fax:866-694-4979
Practice Address - Street 1:140 SOUTHWESTERN DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NY
Practice Address - Zip Code:14750-2117
Practice Address - Country:US
Practice Address - Phone:716-338-0668
Practice Address - Fax:866-694-4979
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020921-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist