Provider Demographics
NPI:1952879504
Name:HYDE, SARAH MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HYDE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:HYDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:609 TAYMAN DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-3829
Mailing Address - Country:US
Mailing Address - Phone:410-562-9904
Mailing Address - Fax:
Practice Address - Street 1:6700 GLENN DALE RD
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9407
Practice Address - Country:US
Practice Address - Phone:301-805-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist