MEDICARE: SANDRA BUCK 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	13962	NC

General Provider Information

NPI Number	:	1134577844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BUCK M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1203 BRANUM CT
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-5527
Country	:	US
Telephone Number	:	303-888-8410
Fax Number	:

Provider Business Practice Location Address
First Line	:	468 RENAISSANCE DR
Second Line	:
City	:	PITTSBORO
State	:	NC
Zip	:	27312-0980
Country	:	US
Telephone Number	:	919-542-3626
Fax Number	:

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

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	05/27/2026

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Directions to “ SANDRA BUCK M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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