Provider Demographics
NPI:1790134195
Name:GIRARDEAU, AMBER MCCULLAR (AUD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MCCULLAR
Last Name:GIRARDEAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22530 US HIGHWAY 98 STE 240
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-6398
Mailing Address - Country:US
Mailing Address - Phone:251-929-9397
Mailing Address - Fax:251-929-9396
Practice Address - Street 1:22530 US HIGHWAY 98 STE 240
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-6398
Practice Address - Country:US
Practice Address - Phone:251-929-9397
Practice Address - Fax:251-929-9396
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1169A237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter