Provider Demographics
NPI:1124362983
Name:SCHIEBOUT, SARA ELIZABETH (MS)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH
Last Name:SCHIEBOUT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-3218
Mailing Address - Country:US
Mailing Address - Phone:715-834-6681
Mailing Address - Fax:
Practice Address - Street 1:550 N DEWEY ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3218
Practice Address - Country:US
Practice Address - Phone:715-834-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4903125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional