Provider Demographics
NPI:1255944963
Name:SANCHEZ, BIANCA (MA SLP-CF)
Entity type:Individual
Prefix:MS
First Name:BIANCA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MA SLP-CF
Other - Prefix:MRS
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5522 WATERMAN BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-1833
Mailing Address - Country:US
Mailing Address - Phone:847-804-1198
Mailing Address - Fax:
Practice Address - Street 1:105 8TH ST.
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:MO
Practice Address - Zip Code:63389
Practice Address - Country:US
Practice Address - Phone:636-668-8195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist