Healthcare Provider Details

I. General information

NPI: 1255459376
Provider Name (Legal Business Name): FAMILY AUDIOLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S MAIN ST SUITE 4
CELINA OH
45822-2479
US

IV. Provider business mailing address

950 S MAIN ST SUITE 4
CELINA OH
45822-2479
US

V. Phone/Fax

Practice location:
  • Phone: 419-584-2255
  • Fax:
Mailing address:
  • Phone: 419-584-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ELLEN HUNTER
Title or Position: CO-OWNER
Credential: AU.D.
Phone: 419-584-2255