Provider Demographics
NPI:1942913439
Name:BOLLA, SARAH CAROLYN (SLP ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:CAROLYN
Last Name:BOLLA
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:DULKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2008 GRAYSTONE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2545
Mailing Address - Country:US
Mailing Address - Phone:832-928-7715
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4959
Practice Address - Country:US
Practice Address - Phone:936-293-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX416242355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant