Provider Demographics
NPI:1699085118
Name:FRIEDMAN, SARA L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:FRIEDMAN
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 1:108 STRATFORD PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1467
Mailing Address - Country:US
Mailing Address - Phone:732-364-7558
Mailing Address - Fax:
Practice Address - Street 1:108 STRATFORD PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1467
Practice Address - Country:US
Practice Address - Phone:732-364-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist