Provider Demographics
NPI:1275679276
Name:AARON, ROXANNE J (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:J
Last Name:AARON
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5042
Mailing Address - Country:US
Mailing Address - Phone:901-678-5800
Mailing Address - Fax:901-525-1282
Practice Address - Street 1:807 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-5042
Practice Address - Country:US
Practice Address - Phone:901-678-5800
Practice Address - Fax:901-525-1282
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01772231HA2400X
TN1509231H00000X
MO1772231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1515206Medicaid
MO333348316Medicaid