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NPI Code Detail

MEDICARE: MARY J. SANDAGE M.S., CCC-SLP

MEDICARE: MARY J. SANDAGE 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
1235Z00000XSpeech-Language Pathologist2436AL

General Provider Information

NPI Number : 1336364835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J. SANDAGE M.S., CCC-SLP
Provider Business Mailing Address
First Line : 710 SANDERS ST
Second Line :
City : AUBURN
State : AL
Zip : 36830-3036
Country : US
Telephone Number : 334-332-8849
Fax Number :
Provider Business Practice Location Address
First Line : 1199 HALEY CENTER
Second Line :
City : AUBURN
State : AL
Zip : 36849-4013
Country : US
Telephone Number : 334-844-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 05/22/2023

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