Russell, Sara

Russell, Sara is an individual health care provider with primary practice located at 135 Gold Star Blvd , Worcester MA 01606. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Russell, Sara can be contacted via phone (508) 852-0600.

Contact Information

Primary practice address
135 Gold Star Blvd Worcester MA 01606
Phone: (508) 852-0600
Fax: (508) 853-1907
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 6577 Maryland

Profile Details

NPI number 1376517383
LBN Legal business name Russell, Sara
Credentials CCC SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Feb 25th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376517383 NPPES
Other 042472266 TRICARE CHAMPUS
MEDICAID 0708925 TRICARE CHAMPUS
Other 90920 TRICARE CHAMPUS

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