Healthcare Provider Details

I. General information

NPI: 1801934161
Provider Name (Legal Business Name): SARAH LYNN SHIRA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 COUNTY ROAD 184
CARDINGTON OH
43315-9359
US

IV. Provider business mailing address

2550 COUNTY ROAD 184
CARDINGTON OH
43315-9359
US

V. Phone/Fax

Practice location:
  • Phone: 614-325-3555
  • Fax:
Mailing address:
  • Phone: 614-325-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-7712
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: