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Individual

GWEN GENEEN WASHBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-A

Contact information

Practice address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989
Mailing address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7051
MN
237700000X
Hearing Instrument Specialist
7051
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7051
AUDIOLOGY LICENSE
MN
Enumeration date
05/17/2006
Last updated
10/06/2008
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