Provider Demographics
NPI:1841969078
Name:HACKENBRACHT, SARAH ADELINE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ADELINE
Last Name:HACKENBRACHT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ADELINE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1124 COURTNEY LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2565
Mailing Address - Country:US
Mailing Address - Phone:972-809-9510
Mailing Address - Fax:
Practice Address - Street 1:1800 W ROSEMEADE PKWY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2742
Practice Address - Country:US
Practice Address - Phone:972-968-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist