Individual
MRS. JAN H HENRIQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
203 WOODPARK PLACE, SUITE B-100, WOODSTOCK, GA 30188
(770) 560-4775
(770) 234-6977
Mailing address
203 WOODPARK PLACE, SUITE B-100, WOODSTOCK, GA 30188
(770) 560-4775
(770) 234-6977
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
1690
GA
237600000X
Audiologist-Hearing Aid Fitter
Primary
001690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000784506A
—
GA
05
—
000876752A
—
GA
Enumeration date
01/15/2007
Last updated
04/30/2014
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