Healthcare Provider Details

I. General information

NPI: 1356450209
Provider Name (Legal Business Name): BARI F LEVENS AUD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARI A FRIEDBERG AUD, CCC-A

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 DANTIGNAC STREET SUITE 1000
AUGUSTA GA
30901-2776
US

IV. Provider business mailing address

340 NORTH BELAIR ROAD
EVANS GA
30809-3000
US

V. Phone/Fax

Practice location:
  • Phone: 706-868-5676
  • Fax: 706-722-2824
Mailing address:
  • Phone: 706-868-5676
  • Fax: 706-722-2824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberAUD003739
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD0003739
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: