Provider Demographics
NPI:1154915882
Name:CENCER, SABRINA (SLP)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CENCER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6003
Mailing Address - Country:US
Mailing Address - Phone:318-322-6500
Mailing Address - Fax:318-322-5118
Practice Address - Street 1:1300 HUDSON LN STE 7
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6054
Practice Address - Country:US
Practice Address - Phone:318-361-7180
Practice Address - Fax:318-582-5615
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist