Provider Demographics
NPI:1710053749
Name:BONNETT, SARAH CATHARINE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:CATHARINE
Last Name:BONNETT
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 1:5992 S KURTZ RD APT 11
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1785
Mailing Address - Country:US
Mailing Address - Phone:414-266-4923
Mailing Address - Fax:414-266-6189
Practice Address - Street 1:9000 W WISCONSIN AVE STE B340
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2934
Practice Address - Fax:414-266-6189
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI490-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1710053749Medicaid