Provider Demographics
NPI:1669562450
Name:SCHAFER, SALLY A (MA, CCC-A)
Entity type:Individual
Prefix:MS
First Name:SALLY
Middle Name:A
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CASMIN HEARING GROUP, LLC
Mailing Address - Street 2:10869 N SCOTTSDALE RD,, STE 103-147
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5280
Mailing Address - Country:US
Mailing Address - Phone:480-687-8111
Mailing Address - Fax:
Practice Address - Street 1:BELTONE HEARING CARE CENTER
Practice Address - Street 2:7725 N ORACLE RD., STE 121
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-639-9367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30780231H00000X
AZDA9694237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500689801Medicaid