Healthcare Provider Details

I. General information

NPI: 1275102584
Provider Name (Legal Business Name): KATIE L SEEVER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 W THUNDERBIRD RD STE F600
GLENDALE AZ
85306-4667
US

IV. Provider business mailing address

4225 N 12TH ST APT 1111
PHOENIX AZ
85014-4621
US

V. Phone/Fax

Practice location:
  • Phone: 602-863-4203
  • Fax: 602-863-4216
Mailing address:
  • Phone: 918-214-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: