Provider Demographics
NPI:1285326272
Name:WILDES, SARAH MARGARET (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARGARET
Last Name:WILDES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4186
Mailing Address - Country:US
Mailing Address - Phone:603-598-0729
Mailing Address - Fax:603-598-0864
Practice Address - Street 1:5 GEORGE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4186
Practice Address - Country:US
Practice Address - Phone:603-598-0729
Practice Address - Fax:603-598-0864
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist