Provider Demographics
NPI:1487161428
Name:CUSTER, SARAH
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:CUSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 MISSION RD STE B4
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1362
Mailing Address - Country:US
Mailing Address - Phone:913-948-4223
Mailing Address - Fax:816-222-0679
Practice Address - Street 1:8340 MISSION RD STE B4
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1362
Practice Address - Country:US
Practice Address - Phone:913-948-4223
Practice Address - Fax:816-222-0679
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist