Provider Demographics
NPI:1104198530
Name:HESS, SANDRA L
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:HESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WYNDGATE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12577-5410
Mailing Address - Country:US
Mailing Address - Phone:845-496-8807
Mailing Address - Fax:
Practice Address - Street 1:70 KUKUK LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6943
Practice Address - Country:US
Practice Address - Phone:845-336-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004951-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist