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Individual
DR. SARA MICHELLE BODACK
Active
Individual
DR. SARA MICHELLE BODACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
80250
TX
231H00000X
Audiologist
Primary
LD60953985
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208820501
—
TX
05
—
2138409
—
WA
01
—
P008004030
RAILROAD
TX
Enumeration date
08/10/2009
Last updated
09/30/2019
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