Healthcare Provider Details

I. General information

NPI: 1538045505
Provider Name (Legal Business Name): MAISON DREY LARMORE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 DATA PARK
HOOVER AL
35244-1203
US

IV. Provider business mailing address

3027 PARKRIDGE DR APT 4
BIRMINGHAM AL
35209-2422
US

V. Phone/Fax

Practice location:
  • Phone: 205-733-9694
  • Fax:
Mailing address:
  • Phone: 228-697-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1416A
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: