Basic Information
| Provider Information | |||||||||
| NPI: | 1699159327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLINAK | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | BLACKMAN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSP, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1180 WHISPER TRACE LN | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379198684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646809261 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 S GALLAHER VIEW RD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379195355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156148833 | ||||||||
| FaxNumber: | 6156148811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2015 | ||||||||
| LastUpdateDate: | 07/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 5378 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.