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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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