Healthcare Provider Details

I. General information

NPI: 1184549073
Provider Name (Legal Business Name): MARA LOUISE SMITH AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9465 E IRONWOOD SQUARE DR STE 102
SCOTTSDALE AZ
85258-4579
US

IV. Provider business mailing address

9465 E IRONWOOD SQUARE DR STE 102
SCOTTSDALE AZ
85258-4579
US

V. Phone/Fax

Practice location:
  • Phone: 480-588-3180
  • Fax:
Mailing address:
  • Phone: 480-588-3180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA17628
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: