Provider Demographics
NPI:1881288280
Name:HOTALING, KARA A (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:A
Last Name:HOTALING
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 S WHITMAN CT SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-7711
Mailing Address - Country:US
Mailing Address - Phone:616-570-0641
Mailing Address - Fax:
Practice Address - Street 1:500 LAFAYETTE AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1658
Practice Address - Country:US
Practice Address - Phone:616-331-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000558231H00000X
NC3865231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist