Provider Demographics
NPI:1023187531
Name:NORTHSHORE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:NORTHSHORE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:ABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-649-9131
Mailing Address - Street 1:2238 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4231
Mailing Address - Country:US
Mailing Address - Phone:985-649-9131
Mailing Address - Fax:985-649-9498
Practice Address - Street 1:2238 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4231
Practice Address - Country:US
Practice Address - Phone:985-649-9131
Practice Address - Fax:985-649-9498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5375237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty