Provider Demographics
NPI:1497869093
Name:MICHAEL, SARA E (AUD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:MICHAEL
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 1:1000 73RD ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1321
Mailing Address - Country:US
Mailing Address - Phone:515-440-3323
Mailing Address - Fax:515-440-0344
Practice Address - Street 1:1000 73RD ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1321
Practice Address - Country:US
Practice Address - Phone:515-440-3323
Practice Address - Fax:515-440-0344
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00488231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI12735Medicare ID - Type Unspecified