Individual
MRS. SUZANNE S STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
1722 PINE ST, SUITE 804, MONTGOMERY, AL 36106-1103
(334) 834-7221
Mailing address
1722 PINE ST, SUITE 804, MONTGOMERY, AL 36106-1103
(334) 834-7221
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
955A
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4149
DISPENSER LICENSE
AL
01
—
955A
ALABAMA AUDIOLOGY LICENSE NUMBER
AL
Enumeration date
09/08/2008
Last updated
09/08/2008
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