Provider Demographics
NPI:1538358171
Name:SHOFF, SARA BETH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:SHOFF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SPARKS STATION RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9334
Mailing Address - Country:US
Mailing Address - Phone:443-834-2660
Mailing Address - Fax:443-923-1895
Practice Address - Street 1:1 SPARKS STATION RD
Practice Address - Street 2:
Practice Address - City:SPARKS GLENCOE
Practice Address - State:MD
Practice Address - Zip Code:21152-9334
Practice Address - Country:US
Practice Address - Phone:443-834-2660
Practice Address - Fax:443-923-1895
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist