Healthcare Provider Details

I. General information

NPI: 1740200054
Provider Name (Legal Business Name): DEEPA HARIPRASAD AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRNMMC 8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

WRNMMC 8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 808-497-4420
  • Fax:
Mailing address:
  • Phone: 808-497-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number5231
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: