Provider Demographics
NPI:1225386261
Name:LEA, SARAH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LEA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SILVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:10226 GRAPE CREEK GROVE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-4042
Mailing Address - Country:US
Mailing Address - Phone:936-703-5064
Mailing Address - Fax:844-559-5504
Practice Address - Street 1:12075 SPRING CYPRESS RD STE A
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8040
Practice Address - Country:US
Practice Address - Phone:936-703-5064
Practice Address - Fax:844-559-5504
Is Sole Proprietor?:No
Enumeration Date:2012-08-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109578235Z00000X, 235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX345078501Medicaid
TX109578OtherTEXAS STATE BOARD OF EXAMINERS OF SPEECH-LANGUAGE PATHOLOGY
CO14063561OtherASHA CERTIFICATION