Provider Demographics
NPI:1902890734
Name:MUHLBACH, SALLY E (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:E
Last Name:MUHLBACH
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 E LUFKIN AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-4043
Mailing Address - Country:US
Mailing Address - Phone:936-632-2252
Mailing Address - Fax:936-632-0712
Practice Address - Street 1:609 E LUFKIN AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-4043
Practice Address - Country:US
Practice Address - Phone:936-632-2252
Practice Address - Fax:936-632-0712
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51152231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX022388501Medicaid
TX022388503OtherMEDICAID-HEARING EVALUATION
TX022388501OtherMEDICAID-HEARING AID
TX0A4522OtherMEDICARE-GROUP
TX022388501Medicaid