Healthcare Provider Details

I. General information

NPI: 1841448164
Provider Name (Legal Business Name): WENDY B CATES AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY BETH CATES AU.D

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 LACY ST NW
MARIETTA GA
30060-1107
US

IV. Provider business mailing address

80 LACY ST NW
MARIETTA GA
30060-1107
US

V. Phone/Fax

Practice location:
  • Phone: 770-427-0368
  • Fax: 770-427-0368
Mailing address:
  • Phone: 770-427-0368
  • Fax: 770-427-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0491
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number9874
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number9874
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: