Provider Demographics
NPI:1700174786
Name:BOHLER, ABBY CAUDLE (AUD)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:CAUDLE
Last Name:BOHLER
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 1:6975 COBB INTERNATIONAL BLVD NW
Mailing Address - Street 2:AUDIOLOGY SERVICES
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6975 COBB INTERNATIONAL BLVD NW
Practice Address - Street 2:AUDIOLOGY SERVICES
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7621
Practice Address - Country:US
Practice Address - Phone:678-581-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003877231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist