Healthcare Provider Details

I. General information

NPI: 1023323821
Provider Name (Legal Business Name): HEARING PROFESSIONALS, INC OF WALDORF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23077 THREE NOTCH RD SUITE 101
CALIFORNIA MD
20619-2409
US

IV. Provider business mailing address

3406 OLD WASHINGTON RD SUITE 203
WALDORF MD
20602-3207
US

V. Phone/Fax

Practice location:
  • Phone: 301-737-4040
  • Fax:
Mailing address:
  • Phone: 301-932-4237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. TRACEY L NALESNIK
Title or Position: EXEC. DIR.
Credential:
Phone: 301-932-4237