MEDICARE: SARAH HALE MS, CCC-SLP

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	113404	TX

General Provider Information

NPI Number	:	1700397361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HALE MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3008 WORTH LN
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-8178
Country	:	US
Telephone Number	:	210-569-4893
Fax Number	:

Provider Business Practice Location Address
First Line	:	3008 WORTH LN
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-8178
Country	:	US
Telephone Number	:	210-569-4893
Fax Number	:

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

Provider Enumeration Date	:	10/22/2017
Last Update Date	:	01/20/2022

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