Provider Demographics
NPI:1922756246
Name:SHIMMEL, SARAH (HIS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SHIMMEL
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N MCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6784
Mailing Address - Country:US
Mailing Address - Phone:248-787-6593
Mailing Address - Fax:
Practice Address - Street 1:3200 CABARET TRL S
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2240
Practice Address - Country:US
Practice Address - Phone:989-790-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501008267237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist