Provider Demographics
NPI:1972832335
Name:SAIA, MARTHA T
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:T
Last Name:SAIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1966 HILL DR
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-5047
Mailing Address - Country:US
Mailing Address - Phone:662-226-2442
Mailing Address - Fax:662-226-9567
Practice Address - Street 1:1966 HILL DR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-5047
Practice Address - Country:US
Practice Address - Phone:662-226-2442
Practice Address - Fax:662-226-9567
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS0465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist