Healthcare Provider Details

I. General information

NPI: 1235938150
Provider Name (Legal Business Name): CIARA MARIE HOULIHAN AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NGMC - HABERSHAM 541 HISTORIC HWY, 441-N
DEMOREST GA
30535
US

IV. Provider business mailing address

10201 ELM GROVE AVE
GAINESVILLE GA
30501-3952
US

V. Phone/Fax

Practice location:
  • Phone: 706-839-4050
  • Fax: 888-965-9908
Mailing address:
  • Phone: 703-283-6391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD004436
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAUD004436
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAUD004436
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: