Healthcare Provider Details

I. General information

NPI: 1649796681
Provider Name (Legal Business Name): SARAH MARIE HENDERSON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 W MAIN ST STE 17
CHESTER NJ
07930-2487
US

IV. Provider business mailing address

95 W MAIN ST STE 17
CHESTER NJ
07930-2487
US

V. Phone/Fax

Practice location:
  • Phone: 908-879-7067
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number027003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: