MEDICARE: SARAH SRAJ 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	SP.13038	OH

General Provider Information

NPI Number	:	1073138970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH SRAJ M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	6451 CENTER ST
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4196
Country	:	US
Telephone Number	:	440-255-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	5028 FOREST RD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-1308
Country	:	US
Telephone Number	:	440-257-5951
Fax Number	:

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

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	06/16/2020

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Directions to “ SARAH SRAJ M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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