Provider Demographics
NPI:1073700613
Name:RANK, SARAH JOY (AUD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JOY
Last Name:RANK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 WILL ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4236
Mailing Address - Country:US
Mailing Address - Phone:770-228-5667
Mailing Address - Fax:
Practice Address - Street 1:653 WILL ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4236
Practice Address - Country:US
Practice Address - Phone:770-228-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003633231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000977061CMedicaid
GA000977061CMedicaid