Individual
ANN LOUISE WIDENER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
968 RIBAUT RD, STE 2, BEAUFORT, SC 29902-5486
(843) 524-7920
(843) 525-1230
Mailing address
968 RIBAUT RD, STE 2, BEAUFORT, SC 29902-5486
(843) 524-7920
(843) 525-1230
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
566
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1494
—
SC
05
—
SA0018
—
SC
Enumeration date
01/03/2006
Last updated
07/08/2007
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