Provider Demographics
NPI:1336556174
Name:ALEXANDER, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ALEXANDER
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 1:22170 YANKEE TOWN RD
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-8229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:228-861-3202
Practice Address - Street 1:22170 YANKEE TOWN RD
Practice Address - Street 2:
Practice Address - City:SAUCIER
Practice Address - State:MS
Practice Address - Zip Code:39574
Practice Address - Country:US
Practice Address - Phone:228-861-3202
Practice Address - Fax:228-861-3202
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3957235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist