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Organization
ST. JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization
ST. JOHN HOSPITAL AND MEDICAL CENTER
Active
Other names
Lakeshore Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA WHITMAN (DIRECTOR)
(248) 849-4229
Entity
Organization
Contact information
Practice address
21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
(586) 779-7610
(586) 779-1391
Mailing address
21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
(586) 779-7610
(586) 779-1391
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
MI
231HA2400X
Assistive Technology Practitioner Audiologist
—
MI
231HA2500X
Assistive Technology Supplier Audiologist
—
MI
235500000X
Speech/Language/Hearing Specialist/Technologist
—
MI
2355A2700X
Audiology Assistant
—
MI
2355S0801X
Speech-Language Assistant
—
MI
235Z00000X
Speech-Language Pathologist
—
MI
237600000X
Audiologist-Hearing Aid Fitter
—
MI
237700000X
Hearing Instrument Specialist
—
MI
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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