MEDICARE: SARA MARIE KULL MA 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.08620	OH
2	235Z00000X	Speech-Language Pathologist	SP.8620	OH

General Provider Information

NPI Number	:	1992240469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MARIE KULL MA CCC-SLP

Provider Business Mailing Address
First Line	:	1440 ROCKSIDE RD STE 201
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-2749
Country	:	US
Telephone Number	:	440-427-4433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 ROCKSIDE RD STE 201
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-2749
Country	:	US
Telephone Number	:	440-427-4433
Fax Number	:

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

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	07/21/2022

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Directions to “ SARA MARIE KULL MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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