Provider Demographics
NPI:1316934821
Name:HIRSHBURG, SANDRA TANNER (MMS,CCC-ASLP,FAAA)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:TANNER
Last Name:HIRSHBURG
Suffix:
Gender:F
Credentials:MMS,CCC-ASLP,FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 HIDDEN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-8501
Mailing Address - Country:US
Mailing Address - Phone:828-697-2153
Mailing Address - Fax:828-697-2153
Practice Address - Street 1:175 HIDDEN LAKE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-8501
Practice Address - Country:US
Practice Address - Phone:828-697-2153
Practice Address - Fax:828-697-2153
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1096231HA2400X, 231HA2500X, 237600000X, 231H00000X
NC1866235Z00000X
NC841237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist