Provider Demographics
NPI:1003121476
Name:CANCHE, SARAH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CANCHE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-0155
Mailing Address - Country:US
Mailing Address - Phone:956-342-2245
Mailing Address - Fax:
Practice Address - Street 1:903 N FLAG ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2912
Practice Address - Country:US
Practice Address - Phone:956-354-2200
Practice Address - Fax:956-354-3034
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058222355S0801X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167033301Medicaid