# NW DIAGNOSTIC AUDIOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760542310
- **Authorized official:** MRS. CINDY L ROBERTS MSCCCA (OWNER)
- **Authorized official phone:** (580) 233-4129

## Contact information

- **Practice address:** 3201 N VAN BUREN, SUITE 200, ENID, OK 73703
- **Practice address phone:** (580) 233-4129
- **Practice address fax:** (580) 233-4130
- **Mailing address:** 3201 N VAN BUREN, SUITE 200, ENID, OK 73703
- **Mailing address phone:** (580) 233-4129
- **Mailing address fax:** (580) 233-4130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 219 | OK | Yes |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1006682200 | — | OK |