Provider Demographics
NPI:1235498502
Name:CORNERSTONE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:CORNERSTONE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:T
Authorized Official - Last Name:WAKEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:970-302-2389
Mailing Address - Street 1:1197 FALL RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-8771
Mailing Address - Country:US
Mailing Address - Phone:970-302-2389
Mailing Address - Fax:
Practice Address - Street 1:403 SUMMIT BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8252
Practice Address - Country:US
Practice Address - Phone:970-302-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO592231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty