Healthcare Provider Details

I. General information

NPI: 1649377748
Provider Name (Legal Business Name): BEATRIZ OLGA WEGE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8952 E DESERT COVE AVE SUITE 205
SCOTTSDALE AZ
85260-6775
US

IV. Provider business mailing address

8952 E DESERT COVE AVE SUITE 205
SCOTTSDALE AZ
85260-6775
US

V. Phone/Fax

Practice location:
  • Phone: 480-273-8688
  • Fax: 480-273-8689
Mailing address:
  • Phone: 480-273-8688
  • Fax: 480-273-8689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA5111
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: