Provider Demographics
NPI:1942758560
Name:HALTER, SARAH (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HALTER
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MENEZES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:5000 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-2015
Mailing Address - Country:US
Mailing Address - Phone:314-752-0000
Mailing Address - Fax:
Practice Address - Street 1:5000 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-2015
Practice Address - Country:US
Practice Address - Phone:314-752-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO201600072235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist