Provider Demographics
NPI:1295622462
Name:LINDBERG, SARA CHRISTINE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CHRISTINE
Last Name:LINDBERG
Suffix:
Gender:X
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-9714
Mailing Address - Country:US
Mailing Address - Phone:616-745-6440
Mailing Address - Fax:
Practice Address - Street 1:1500 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7955
Practice Address - Country:US
Practice Address - Phone:989-860-0846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101008974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist