Provider Demographics
NPI:1639294382
Name:KOEHLER, SARAH WHITESCARVER
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:WHITESCARVER
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1494
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-1494
Mailing Address - Country:US
Mailing Address - Phone:704-829-6074
Mailing Address - Fax:
Practice Address - Street 1:5110 PARK RD
Practice Address - Street 2:SUITE 1-C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3699
Practice Address - Country:US
Practice Address - Phone:704-405-0155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC708237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC570896323OtherTAX ID NUMBER