Provider Demographics
NPI:1528322823
Name:DUCKERY, DEVLIN KEOMIE (AUD)
Entity type:Individual
Prefix:MS
First Name:DEVLIN
Middle Name:KEOMIE
Last Name:DUCKERY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HARMONY CT
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3613
Mailing Address - Country:US
Mailing Address - Phone:202-417-5217
Mailing Address - Fax:
Practice Address - Street 1:8 HARMONY CT
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3613
Practice Address - Country:US
Practice Address - Phone:202-417-5217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD004117231H00000X
DEO2-0000201237600000X
SC4093231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter