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Individual

MS. VICKI MARIE CONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
620 10TH STREET N., ST PETERSBURG, FL 33705-1407
(727) 824-7170
(727) 824-7142
Mailing address
PO BOX 12868, ST PETERSBURG, FL 33733-2868
(727) 532-1355
(727) 266-4928

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY 744
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004338301
FL
Enumeration date
06/15/2007
Last updated
03/31/2014
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