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Individual

ANDREA JAE SUDDERTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
HAD

Contact information

Practice address
32 JOHNSON DR, BRASELTON, GA 30517-2774
(770) 853-9206
Mailing address
20 PAULA ST, COMMERCE, GA 30529-1626
(706) 870-3970

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HADS001065
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HADS001065
HEARING AID DISPENSER
GA
Enumeration date
12/09/2021
Last updated
11/15/2023
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