Provider Demographics
NPI:1235890500
Name:SAUER, SANDRA J (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:SAUER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 FALLKIRK DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2084
Mailing Address - Country:US
Mailing Address - Phone:972-899-0638
Mailing Address - Fax:
Practice Address - Street 1:300 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4142
Practice Address - Country:US
Practice Address - Phone:214-496-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist