Provider Demographics
NPI:1487849493
Name:AUDIOLOGY FIRST, LLC
Entity Type:Organization
Organization Name:AUDIOLOGY FIRST, LLC
Other - Org Name:DIANA J. WAGNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-964-9511
Mailing Address - Street 1:8850 STANFORD BLVD STE 1700
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4765
Mailing Address - Country:US
Mailing Address - Phone:410-964-9511
Mailing Address - Fax:410-964-9513
Practice Address - Street 1:8850 STANFORD BLVD STE 1700
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4765
Practice Address - Country:US
Practice Address - Phone:410-964-9511
Practice Address - Fax:410-964-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD562237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD236MMedicare PIN