Basic Information
| Provider Information | |||||||||
| NPI: | 1548749815 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRAUSE | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | LYNN | ||||||||
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| OtherOrganizationType: | |||||||||
| OtherLastName: | PENDLETON | ||||||||
| OtherFirstName: | SARA | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7 DOCK HILL RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178428910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708372123 | ||||||||
| FaxNumber: | 5708372185 | ||||||||
| Practice Location | |||||||||
| Address1: | 248 GRANITE RUN DR | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176016804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175602917 | ||||||||
| FaxNumber: | 7175602985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2018 | ||||||||
| LastUpdateDate: | 03/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL011277 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.