Provider Demographics
NPI:1043613367
Name:LENON, SANDRA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LENON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-6437
Mailing Address - Country:US
Mailing Address - Phone:479-631-3535
Mailing Address - Fax:
Practice Address - Street 1:2926 S 1ST ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-6437
Practice Address - Country:US
Practice Address - Phone:479-631-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist