Provider Demographics
NPI:1699421297
Name:PRINCE, SARA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:PRINCE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MCKINNEY AVE
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:TX
Mailing Address - Zip Code:75407-6690
Mailing Address - Country:US
Mailing Address - Phone:760-405-6451
Mailing Address - Fax:
Practice Address - Street 1:7009 WOODBRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-5696
Practice Address - Country:US
Practice Address - Phone:760-405-6451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117823235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist