Provider Demographics
NPI:1942558226
Name:CAMPAU, SARAH C (BA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:CAMPAU
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 CLIFFORD AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2360
Mailing Address - Country:US
Mailing Address - Phone:616-942-2722
Mailing Address - Fax:616-942-2515
Practice Address - Street 1:940 CLIFFORD AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2360
Practice Address - Country:US
Practice Address - Phone:616-942-2722
Practice Address - Fax:616-942-2515
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator