Healthcare Provider Details

I. General information

NPI: 1932052438
Provider Name (Legal Business Name): REIHANEH ASADI HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 HEMINGWAY LN
ROSWELL GA
30075-7007
US

IV. Provider business mailing address

831 HEMINGWAY LN
ROSWELL GA
30075-7007
US

V. Phone/Fax

Practice location:
  • Phone: 470-461-7991
  • Fax:
Mailing address:
  • Phone: 470-461-7991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS001179
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: