Provider Demographics
NPI:1851646012
Name:MORAN, SANDY M (BACHELORS DEGGRE)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:M
Last Name:MORAN
Suffix:
Gender:F
Credentials:BACHELORS DEGGRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21550 PROVINCIAL BLVD APT 1603
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7576
Mailing Address - Country:US
Mailing Address - Phone:646-453-9368
Mailing Address - Fax:
Practice Address - Street 1:14515 BRIARHILLS PKWY STE 208
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1034
Practice Address - Country:US
Practice Address - Phone:917-833-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
TX393932355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant
No174400000XOther Service ProvidersSpecialist