MEDICARE: MISS SARA KATHRYN MASTROPOLE M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202004734	VA

General Provider Information

NPI Number	:	1023035052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARA KATHRYN MASTROPOLE M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1900 S EADS ST
Second Line	:	APT #830
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3027
Country	:	US
Telephone Number	:	703-966-5458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 S EADS ST
Second Line	:	APT #830
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3027
Country	:	US
Telephone Number	:	703-966-5458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	07/08/2007

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Directions to “ MISS SARA KATHRYN MASTROPOLE M.S. CCC-SLP” Practice Location

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