Provider Demographics
NPI:1467601682
Name:SANDLIN, SALLY K (ST)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:K
Last Name:SANDLIN
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 S WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-3439
Mailing Address - Country:US
Mailing Address - Phone:469-595-3737
Mailing Address - Fax:972-932-5970
Practice Address - Street 1:1701 S WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-3439
Practice Address - Country:US
Practice Address - Phone:469-595-3737
Practice Address - Fax:972-932-5970
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX345902355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant