Provider Demographics
NPI:1235548645
Name:WINCHESTER, SANDRA MEADOR (SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MEADOR
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:MEADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:8834 BERGENIA CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6777
Mailing Address - Country:US
Mailing Address - Phone:614-354-7957
Mailing Address - Fax:
Practice Address - Street 1:1545 HUY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3531
Practice Address - Country:US
Practice Address - Phone:614-365-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist