MEDICARE: SARAH CASE GIAMMALVA

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	118476

General Provider Information

NPI Number	:	1053036137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH CASE GIAMMALVA

Provider Business Mailing Address
First Line	:	1400 JANWOOD DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-7231
Country	:	US
Telephone Number	:	469-752-3276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 JANWOOD DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-7231
Country	:	US
Telephone Number	:	469-752-3276
Fax Number	:

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

Provider Enumeration Date	:	10/11/2022
Last Update Date	:	10/11/2022

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Directions to “ SARAH CASE GIAMMALVA ” Practice Location

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