Provider Demographics
NPI:1093936916
Name:HEARING PROFESSIONALS, INC
Entity Type:Organization
Organization Name:HEARING PROFESSIONALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:301-604-3177
Mailing Address - Street 1:14201 LAUREL PARK DR
Mailing Address - Street 2:STE 109
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5203
Mailing Address - Country:US
Mailing Address - Phone:301-604-3177
Mailing Address - Fax:301-604-2919
Practice Address - Street 1:14201 LAUREL PARK DR
Practice Address - Street 2:STE 109
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:301-604-3177
Practice Address - Fax:301-604-2919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARING PROFESSIONALS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-01
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00024Medicare PIN