Provider Demographics
NPI:1154738904
Name:MISHEK, SARA A
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:MISHEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:MUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:50533-2203
Mailing Address - Country:US
Mailing Address - Phone:402-278-0872
Mailing Address - Fax:
Practice Address - Street 1:1020 BUDDY HOLLY PL
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-3735
Practice Address - Country:US
Practice Address - Phone:641-231-2984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst