Healthcare Provider Details

I. General information

NPI: 1184399875
Provider Name (Legal Business Name): PINNACLE AUDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 S MINNESOTA AVE STE 101
SIOUX FALLS SD
57108-2570
US

IV. Provider business mailing address

6809 S MINNESOTA AVE STE 101
SIOUX FALLS SD
57108-2570
US

V. Phone/Fax

Practice location:
  • Phone: 605-306-4481
  • Fax:
Mailing address:
  • Phone: 605-306-4481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA RAE SIEH CERETTO
Title or Position: AUDIOLOGIST/OWNER
Credential: MA, CCC-A, FAAA
Phone: 605-306-4481