Provider Demographics
NPI:1053794669
Name:GREB, SARAH E (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:GREB
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 BARBARO TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-4186
Mailing Address - Country:US
Mailing Address - Phone:314-368-6931
Mailing Address - Fax:
Practice Address - Street 1:3305 E CONTINENTAL RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-2119
Practice Address - Country:US
Practice Address - Phone:314-368-6931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023833-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist