Healthcare Provider Details
I. General information
NPI: 1497594485
Provider Name (Legal Business Name): MYAH STEFFEN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/21/2024
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
368 BIELBY RD STE 101
LAWRENCEBURG IN
47025-1099
US
IV. Provider business mailing address
40 N GRAND AVE STE 103
FORT THOMAS KY
41075-1765
US
V. Phone/Fax
- Phone: 859-781-4900
- Fax: 859-572-3039
- Phone: 859-781-4900
- Fax: 859-572-3039
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 292057 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 23002850A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: