Provider Demographics
NPI:1942618855
Name:DOCTORS OF AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:DOCTORS OF AUDIOLOGY, LLC
Other - Org Name:HEARING PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-464-2036
Mailing Address - Street 1:4000 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE B124
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3104
Mailing Address - Country:US
Mailing Address - Phone:301-464-2036
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR
Practice Address - Street 2:SUITE 109
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:301-604-3177
Practice Address - Fax:301-604-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0594231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty