Provider Demographics
NPI:1215035589
Name:THACH, SINEAD CHINN (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SINEAD
Middle Name:CHINN
Last Name:THACH
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 1:8442 BRITTANIA WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8064
Mailing Address - Country:US
Mailing Address - Phone:214-553-7996
Mailing Address - Fax:214-553-7996
Practice Address - Street 1:8442 BRITTANIA WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8064
Practice Address - Country:US
Practice Address - Phone:214-553-7996
Practice Address - Fax:214-553-7996
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1743320Medicaid
TX528499OtherBCBS PROVIDER ID NUMBER
TX1053379Medicare UPIN