MEDICARE: BETHANY MARIE SANDERS

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	22009069A	IN
2	235Z00000X	Speech-Language Pathologist	SAH-2026-0020	NM

General Provider Information

NPI Number	:	1972454908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY MARIE SANDERS

Provider Business Mailing Address
First Line	:	1129 GREENAWAY PL
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3257
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1129 GREENAWAY PL
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3257
Country	:	US
Telephone Number	:	812-572-7219
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ BETHANY MARIE SANDERS ” Practice Location

Language	Start Address	Practice Location

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