Healthcare Provider Details

I. General information

NPI: 1235540709
Provider Name (Legal Business Name): SARAH ELIZABETH KLEIN M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2014
Last Update Date: 05/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E COURT ST
SIDNEY OH
45365-3021
US

IV. Provider business mailing address

129 E COURT ST
SIDNEY OH
45365-3021
US

V. Phone/Fax

Practice location:
  • Phone: 937-498-1354
  • Fax:
Mailing address:
  • Phone: 937-498-1354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP. 7023
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: