Basic Information
| Provider Information | |||||||||
| NPI: | 1225502602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLEUE | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | M.S. CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 LEGACY LN APT 1231 | ||||||||
| Address2: | |||||||||
| City: | BELTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765131842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6787796742 | ||||||||
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| Practice Location | |||||||||
| Address1: | 127 W BROAD ST STE 850 | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706014394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373108500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2019 | ||||||||
| LastUpdateDate: | 01/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 115038 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.