Provider Demographics
NPI:1356723068
Name:COUCH, HAROLD ANDREW (AUD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:ANDREW
Last Name:COUCH
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 W QUEEN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-2815
Mailing Address - Country:US
Mailing Address - Phone:520-796-2710
Mailing Address - Fax:520-796-2698
Practice Address - Street 1:3042 W QUEEN CREEK RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-2815
Practice Address - Country:US
Practice Address - Phone:520-796-2710
Practice Address - Fax:520-796-2698
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA9477231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ178412Medicare PIN