Healthcare Provider Details
I. General information
NPI: 1184232134
Provider Name (Legal Business Name): SARAH ANN BANHAGEL AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/15/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 N 29TH ST
BILLINGS MT
59101-0905
US
IV. Provider business mailing address
PO BOX 35100
BILLINGS MT
59107-5100
US
V. Phone/Fax
- Phone: 406-860-7456
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | SLP-AU-LIC-8813 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | SLP-AUD-LIC-8813 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: