Healthcare Provider Details

I. General information

NPI: 1396810909
Provider Name (Legal Business Name): GOOD SOUND AUDIOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W GUADALUPE RD SUITE 315
GILBERT AZ
85233-3332
US

IV. Provider business mailing address

201 W GUADALUPE RD SUITE 315
GILBERT AZ
85233-3332
US

V. Phone/Fax

Practice location:
  • Phone: 480-497-0780
  • Fax: 480-497-0790
Mailing address:
  • Phone: 480-497-0780
  • Fax: 480-497-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDA0060
License Number StateAZ

VIII. Authorized Official

Name: DR. TINA JANEEN JESSEE
Title or Position: OWNER AUDIOLOGIST
Credential: AU D
Phone: 480-497-0780