Provider Demographics
NPI:1285942623
Name:MALAGA, SARAH LEEANN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEEANN
Last Name:MALAGA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LEEANN
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 JAGUAR CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4231
Mailing Address - Country:US
Mailing Address - Phone:407-259-7290
Mailing Address - Fax:
Practice Address - Street 1:650 JAGUAR CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4231
Practice Address - Country:US
Practice Address - Phone:407-259-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10105235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist