Provider Demographics
NPI:1942945860
Name:SHIRK, SARAH LOUISE (HAS)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LOUISE
Last Name:SHIRK
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 KENT DR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9043
Mailing Address - Country:US
Mailing Address - Phone:937-592-1001
Mailing Address - Fax:937-592-1002
Practice Address - Street 1:250 KENT DR
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9043
Practice Address - Country:US
Practice Address - Phone:937-592-1001
Practice Address - Fax:937-592-1002
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHIL.03436237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist