Healthcare Provider Details

I. General information

NPI: 1659661817
Provider Name (Legal Business Name): SARA NICOLE DIRKS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 MCCALL RD
MANHATTAN KS
66502-5033
US

IV. Provider business mailing address

4432 FILAREE CT
MANHATTAN KS
66502-8867
US

V. Phone/Fax

Practice location:
  • Phone: 785-587-4220
  • Fax: 785-587-4298
Mailing address:
  • Phone: 913-406-5348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2567
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: