Provider Demographics
NPI:1699159327
Name:DOLINAK, SARA BLACKMAN (MSP, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:BLACKMAN
Last Name:DOLINAK
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 WHISPER TRACE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8684
Mailing Address - Country:US
Mailing Address - Phone:864-680-9261
Mailing Address - Fax:
Practice Address - Street 1:301 S GALLAHER VIEW RD
Practice Address - Street 2:SUITE 117
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5355
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:615-614-8811
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist