Basic Information
Provider Information
NPI: 1831865856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TREMBCZYNSKI
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.S. CF-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1611 CHALONE CT
Address2:  
City: CROWN POINT
State: IN
PostalCode: 463073750
CountryCode: US
TelephoneNumber: 2197895834
FaxNumber:  
Practice Location
Address1: 370 W 80TH PL
Address2:  
City: MERRILLVILLE
State: IN
PostalCode: 464105432
CountryCode: US
TelephoneNumber: 2195138311
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/19/2021
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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