Provider Demographics
NPI:1083668016
Name:SEPPI, SARA (AUD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SEPPI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SEPPI-RICKELMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1286 CROWN CT
Mailing Address - Street 2:APT 8
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-3873
Mailing Address - Country:US
Mailing Address - Phone:239-207-7410
Mailing Address - Fax:
Practice Address - Street 1:3200 SHORE DR
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-4292
Practice Address - Country:US
Practice Address - Phone:715-135-3187
Practice Address - Fax:715-735-7072
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI554-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ46281Medicare UPIN
WI401350020Medicare PIN