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

LicenseStateTypeSpecialty
2022034168MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Park Hills, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.