Individual
IDA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
824-1
NY
231HA2400X
Assistive Technology Practitioner Audiologist
824-1
NY
231HA2500X
Assistive Technology Supplier Audiologist
824-1
NY
237600000X
Audiologist-Hearing Aid Fitter
14000011914
NY
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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