Provider Demographics
NPI:1295288652
Name:WINDSOR AUDIOLOGY LLC
Entity type:Organization
Organization Name:WINDSOR AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:970-682-1950
Mailing Address - Street 1:8201 SPINNAKER BAY DR
Mailing Address - Street 2:STE E
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80528-7533
Mailing Address - Country:US
Mailing Address - Phone:970-682-1950
Mailing Address - Fax:
Practice Address - Street 1:8201 SPINNAKER BAY DR
Practice Address - Street 2:STE E
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-7533
Practice Address - Country:US
Practice Address - Phone:970-682-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO772231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty