Healthcare Provider Details

I. General information

NPI: 1144501768
Provider Name (Legal Business Name): RHIANNON DANIELLE WORKMAN MCKAY AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RHIANNON DANIELLE WORKMAN AU.D

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HERITAGE DR STE 1
SOUTHGATE MI
48195-3000
US

IV. Provider business mailing address

23550 SAINT GEORGE CIR
SOUTH LYON MI
48178-9466
US

V. Phone/Fax

Practice location:
  • Phone: 248-756-0898
  • Fax:
Mailing address:
  • Phone: 248-756-0898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3501004575
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number3501004575
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: