Provider Demographics
NPI:1063993806
Name:CUSICK, SARAH ELISABETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELISABETH
Last Name:CUSICK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELISABETH
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8378 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1549
Mailing Address - Country:US
Mailing Address - Phone:240-614-0970
Mailing Address - Fax:
Practice Address - Street 1:4504 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4704
Practice Address - Country:US
Practice Address - Phone:301-881-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10930235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist