Provider Demographics
NPI:1871794792
Name:MAXEY, SARAHANNE MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAHANNE
Middle Name:MARIE
Last Name:MAXEY
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 1:3040 CREEK BRANCH CV
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4461
Mailing Address - Country:US
Mailing Address - Phone:270-313-5220
Mailing Address - Fax:270-691-9119
Practice Address - Street 1:3040 CREEK BRANCH CV
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4461
Practice Address - Country:US
Practice Address - Phone:270-313-5220
Practice Address - Fax:270-691-9119
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist