Provider Demographics
NPI:1154803898
Name:POWER, SARA ANN (MED)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:POWER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 TREETOP DR APT 204
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6633
Mailing Address - Country:US
Mailing Address - Phone:908-591-4704
Mailing Address - Fax:
Practice Address - Street 1:158 PRIMARY SCHOOL DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:VA
Practice Address - Zip Code:22727-3008
Practice Address - Country:US
Practice Address - Phone:540-948-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist