Healthcare Provider Details

I. General information

NPI: 1841370236
Provider Name (Legal Business Name): SARA STONE GARRISON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8316 ARLINGTON BLVD SUITE 300
FAIRFAX VA
22031-5207
US

IV. Provider business mailing address

8316 ARLINGTON BLVD SUITE 300
FAIRFAX VA
22031-5207
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-7600
  • Fax: 703-560-3808
Mailing address:
  • Phone: 703-573-7600
  • Fax: 703-560-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number000969
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001236
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: