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Individual

MRS. AUDRA DULAC SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MA, CCC-A

Contact information

Practice address
215 N MAIN ST, WHITE RIVER JUNCTION, VT 05009-0001
(802) 295-9363
Mailing address
223 POVERTY LN, LEBANON, NH 03766-2708
(603) 448-0734

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A405
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09136171
ASHA MEMBER #
01
A405
NHSTATE AUDIOLOGY LICENSE
NH
Enumeration date
06/12/2006
Last updated
07/08/2007
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