Healthcare Provider Details

I. General information

NPI: 1922981190
Provider Name (Legal Business Name): MARY WYNN SAUVAGEAU AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5356 REYNOLDS ST STE 505
SAVANNAH GA
31405-6017
US

IV. Provider business mailing address

1475 RODEO RD APT 320
SANTA FE NM
87505-6857
US

V. Phone/Fax

Practice location:
  • Phone: 912-356-1515
  • Fax: 912-644-0756
Mailing address:
  • Phone: 864-901-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberSAH-2025-0136
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: