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NPI 1073963484

NPI 1073963484 : ANNA CRADY AUD : TUSCALOOSA, AL

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General NPI Number Information
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    NPI Number           |    1073963484
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    Entity Type          |    Individual 
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    Provider Name        |    ANNA CRADY AUD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/16/2016
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    Last Update Date     |    06/16/2016
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Provider Practice Location Address
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    Address Line         |    302 MERCHANTS WALK SUITE 100
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35406-2290
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    Country              |    US
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    Telephone            |    205-523-9300
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    Fax                  |    205-523-9301
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Provider Business Mailing Address
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    Address Line         |    302 MERCHANTS WALK SUITE 100
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35406-2290
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    Country              |    US
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    Telephone            |    205-523-9300
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    Fax                  |    205-523-9301
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    1165A
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    License Number State |    AL
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