MEDICARE: SABRINA DENISE HAGAN

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	:	1982535613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA DENISE HAGAN

Provider Business Mailing Address
First Line	:	104 LEMON GLAZE ST UNIT 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-3975
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 LEMON GLAZE ST UNIT 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-3975
Country	:	US
Telephone Number	:	909-201-4214
Fax Number	:

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

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ SABRINA DENISE HAGAN ” Practice Location

Language	Start Address	Practice Location

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