MEDICARE: SARAH VIRGINIA BLASIUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1033895891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH VIRGINIA BLASIUS

Provider Business Mailing Address
First Line	:	1010 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6914
Country	:	US
Telephone Number	:	586-651-5118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6914
Country	:	US
Telephone Number	:	586-651-5118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/26/2023

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Directions to “ SARAH VIRGINIA BLASIUS ” Practice Location

Language	Start Address	Practice Location

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