Provider Demographics
NPI:1447720578
Name:CINEFRO, SARA JANE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:CINEFRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 FLORAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3255
Mailing Address - Country:US
Mailing Address - Phone:815-307-4807
Mailing Address - Fax:
Practice Address - Street 1:6922 OHIO AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3506
Practice Address - Country:US
Practice Address - Phone:513-793-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2018910-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist