Sage Busenbark, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Park Hills, MO
NPI 1972336253 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1972336253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2022034168 (MO)
- Practice address
- 694 Cochrane Rd
Park Hills, MO 63601-8201 - Phone
- (573) 330-5829
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022034168 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2022034168 | MO | Yes |
Addresses
Primary practice location
694 Cochrane Rd
Park Hills, MO 63601-8201
Mailing address
694 Cochrane Rd
Park Hills, MO 63601-8201
Other providers in Park Hills, MO
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- Richard Barton
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- Julie Brischle
- Sherry Lynn Cauley
- Central School District Riii
- Kathryn Jane Cole
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All providers in Park Hills, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.