Provider Demographics
NPI:1992930382
Name:AUDIOLOGY & HEARING AID ASSOC
Entity type:Organization
Organization Name:AUDIOLOGY & HEARING AID ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:M. SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MA,AUD ( C ), FAAA
Authorized Official - Phone:928-341-1330
Mailing Address - Street 1:2451 S AVENUE A
Mailing Address - Street 2:STE 1
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7133
Mailing Address - Country:US
Mailing Address - Phone:928-341-1330
Mailing Address - Fax:928-341-9748
Practice Address - Street 1:2451 S AVE A
Practice Address - Street 2:STE 1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7133
Practice Address - Country:US
Practice Address - Phone:928-341-1330
Practice Address - Fax:928-341-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA542231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty