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General NPI Number Information
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NPI Number | 1659473122
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Entity Type | Organization
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Legal Business Name | SARAH M. SANDERS SPEECH PATHOLOGIST
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Dates
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Enumeration Date | 09/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 BRAEMOOR PL
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City | LOUISVILLE
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State | KY
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Zip | 40243-1602
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Country | US
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Telephone | 502-417-5127
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Fax | 502-290-3190
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Provider Business Mailing Address
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Address Line | 403 BRAEMOOR PL
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City | LOUISVILLE
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State | KY
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Zip | 40243-1602
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Country | US
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Telephone | 502-417-5127
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Fax | 502-290-3190
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Authorized Official
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Title or Position | OWNER, SPEECH PATHOLOGIST
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Name | MRS. SARAH MULLANEY SANDERS
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Credential | M. S. CCC-SLP
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Telephone | 502-417-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0856
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License Number State | KY
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