Provider Demographics
NPI:1881792869
Name:DADE, WILL D (AUD)
Entity type:Individual
Prefix:DR
First Name:WILL
Middle Name:D
Last Name:DADE
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:PO BOX 51433
Mailing Address - Street 2:
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31995-1433
Mailing Address - Country:US
Mailing Address - Phone:706-544-3633
Mailing Address - Fax:706-544-4418
Practice Address - Street 1:9200 MARNE RD
Practice Address - Street 2:RM 77
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-544-3633
Practice Address - Fax:706-544-4418
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003725231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist