MEDICARE: MILI SARAH JACOB MASLP

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
2	235Z00000X	Speech-Language Pathologist	8745	MA

General Provider Information

NPI Number	:	1376817296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILI SARAH JACOB MASLP

Provider Business Mailing Address
First Line	:	1135 NORTH RD
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1245
Country	:	US
Telephone Number	:	781-888-2829
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 NORTH RD
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1245
Country	:	US
Telephone Number	:	781-888-2829
Fax Number	:

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

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	01/31/2022

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Directions to “ MILI SARAH JACOB MASLP” Practice Location

Language	Start Address	Practice Location

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