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NPI Code Detail

MEDICARE: MS. SANDRA GAUB ST

MEDICARE: MS. SANDRA GAUB ST
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
1235Z00000XSpeech-Language PathologistSP-310NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295822732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA GAUB ST
Provider Business Mailing Address
First Line : 3800 DALECREST DR UNIT 1112B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-1765
Country : US
Telephone Number : 775-315-0235
Fax Number :
Provider Business Practice Location Address
First Line : 6200 W OAKEY BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1103
Country : US
Telephone Number : 702-870-7050
Fax Number : 702-870-7616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 08/05/2013

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Directions to “ MS. SANDRA GAUB ST” Practice Location

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