Provider Demographics
NPI:1447685987
Name:NOBLE-SANDERSON, GAIL M (SLP)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:M
Last Name:NOBLE-SANDERSON
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 1:17347 W SKYRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-7761
Mailing Address - Country:US
Mailing Address - Phone:360-708-1756
Mailing Address - Fax:
Practice Address - Street 1:19710 STATE ROUTE 534
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8026
Practice Address - Country:US
Practice Address - Phone:360-445-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00002784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist