Provider Demographics
NPI:1972171205
Name:CHAMBERS, SARAH NICOLE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 E GRAND AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75223-3650
Mailing Address - Country:US
Mailing Address - Phone:918-671-8511
Mailing Address - Fax:
Practice Address - Street 1:17400 DALLAS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7305
Practice Address - Country:US
Practice Address - Phone:972-665-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist