Provider Demographics
NPI:1447527700
Name:WOHLGEMUTH, SARA RENEE (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:RENEE
Last Name:WOHLGEMUTH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 KENSINGTON PL
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-5164
Mailing Address - Country:US
Mailing Address - Phone:630-549-7160
Mailing Address - Fax:
Practice Address - Street 1:106 KENSINGTON PL
Practice Address - Street 2:APT/SUITE
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-5164
Practice Address - Country:US
Practice Address - Phone:630-549-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist