Provider Demographics
NPI:1225809031
Name:BURKLOW, SARA EMILY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:EMILY
Last Name:BURKLOW
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:EMILY
Other - Last Name:RIDGWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1403 BEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1162
Mailing Address - Country:US
Mailing Address - Phone:609-312-6520
Mailing Address - Fax:
Practice Address - Street 1:115 ROUTE 46 STE B11
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1656
Practice Address - Country:US
Practice Address - Phone:609-920-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01081100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty