Provider Demographics
NPI:1659473122
Name:SARAH M. SANDERS SPEECH PATHOLOGIST
Entity Type:Organization
Organization Name:SARAH M. SANDERS SPEECH PATHOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MULLANEY
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:M S CCC-SLP
Authorized Official - Phone:502-417-5127
Mailing Address - Street 1:403 BRAEMOOR PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1602
Mailing Address - Country:US
Mailing Address - Phone:502-417-5127
Mailing Address - Fax:502-290-3190
Practice Address - Street 1:403 BRAEMOOR PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1602
Practice Address - Country:US
Practice Address - Phone:502-417-5127
Practice Address - Fax:502-290-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty