Provider Demographics
NPI:1235426693
Name:HOUSLEY, SARAH HOFFMAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HOFFMAN
Last Name:HOUSLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3485 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8189
Mailing Address - Country:US
Mailing Address - Phone:931-237-2057
Mailing Address - Fax:
Practice Address - Street 1:161 HATCHER LANE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040
Practice Address - Country:US
Practice Address - Phone:931-542-2168
Practice Address - Fax:931-542-2206
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist