Healthcare Provider Details

I. General information

NPI: 1801157367
Provider Name (Legal Business Name): KRICKET AUDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 KENWOOD RD SUITE C204
BLUE ASH OH
45242-6895
US

IV. Provider business mailing address

9403 KENWOOD RD SUITE C204
BLUE ASH OH
45242-6895
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-4824
  • Fax: 513-936-0600
Mailing address:
  • Phone: 513-936-4824
  • Fax: 513-936-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA01303
License Number StateOH

VIII. Authorized Official

Name: DR. KRISTEN L SMITH
Title or Position: OWNER AND PRACTIONER
Credential: AU.D.
Phone: 513-936-4824