MEDICARE: SARAH RADKE

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	COND.20211919-SP	OH

General Provider Information

NPI Number	:	1093476962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RADKE

Provider Business Mailing Address
First Line	:	5969 LENGWOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-3810
Country	:	US
Telephone Number	:	513-476-7827
Fax Number	:

Provider Business Practice Location Address
First Line	:	5969 LENGWOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-3810
Country	:	US
Telephone Number	:	513-476-7827
Fax Number	:

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

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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Directions to “ SARAH RADKE ” Practice Location

Language	Start Address	Practice Location

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