Provider Demographics
NPI:1831286384
Name:WAKE AUDIOLOGY & HEARING AID ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:WAKE AUDIOLOGY & HEARING AID ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARQUIS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:919-570-8311
Mailing Address - Street 1:1954 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9336
Mailing Address - Country:US
Mailing Address - Phone:919-570-8311
Mailing Address - Fax:
Practice Address - Street 1:1954 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9336
Practice Address - Country:US
Practice Address - Phone:919-570-8311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4617231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412309Medicaid
NC2699675Medicare ID - Type Unspecified