Healthcare Provider Details

I. General information

NPI: 1629492020
Provider Name (Legal Business Name): HEARING MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 LANDING PT
STOCKBRIDGE GA
30281-9060
US

IV. Provider business mailing address

418 LANDING PT
STOCKBRIDGE GA
30281-9060
US

V. Phone/Fax

Practice location:
  • Phone: 404-844-6825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberAUD003830
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAUD003830
License Number StateGA

VIII. Authorized Official

Name: DR. CARLA BRANDILYN SPYIES
Title or Position: DOCTOR OF AUDIOLOGY
Credential: AU.D, CCC-A
Phone: 404-844-6825