Provider Demographics
NPI:1346643897
Name:GOBBEL, SANDRA SCHIMPF
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SCHIMPF
Last Name:GOBBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:SCHIMPF
Other - Last Name:GOBBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOMETRIST
Mailing Address - Street 1:5380 RIVER THAMES RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4631
Mailing Address - Country:US
Mailing Address - Phone:601-942-2798
Mailing Address - Fax:
Practice Address - Street 1:1855 LAKELAND DR STE P121
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4943
Practice Address - Country:US
Practice Address - Phone:601-366-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other