MEDICARE: SARAH GUIGNEAUX M.S., 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	112488	TX

General Provider Information

NPI Number	:	1053935924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH GUIGNEAUX M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	6024 GENTLE KNOLL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-2123
Country	:	US
Telephone Number	:	972-533-1157
Fax Number	:

Provider Business Practice Location Address
First Line	:	6024 GENTLE KNOLL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-2123
Country	:	US
Telephone Number	:	972-533-1157
Fax Number	:

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

Provider Enumeration Date	:	06/05/2020
Last Update Date	:	06/05/2020

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