Provider Demographics
NPI:1497890149
Name:HEPKER, SANDRA JEAN (MS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:HEPKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 EAST SAINT JOE STREET
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242
Mailing Address - Country:US
Mailing Address - Phone:517-439-1610
Mailing Address - Fax:517-439-5679
Practice Address - Street 1:67 EAST SAINT JOE STREET
Practice Address - Street 2:PROFESSIONAL HEARING SERVICES
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242
Practice Address - Country:US
Practice Address - Phone:517-439-1610
Practice Address - Fax:517-439-5679
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000348231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5400010140OtherBCBS
MI640C010120OtherBCBS
MI5400010140OtherBCBS