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General NPI Number Information
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NPI Number | 1326864331
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Entity Type | Individual
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Provider Name | SUSAN MATHEW AUD
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 6475 N DECATUR BLVD STE 125
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City | LAS VEGAS
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State | NV
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Zip | 89131-2943
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Country | US
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Telephone | 702-933-9103
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Fax | 702-933-9104
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Provider Business Mailing Address
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Address Line | 6475 N DECATUR BLVD STE 125
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City | LAS VEGAS
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State | NV
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Zip | 89131-2943
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Country | US
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Telephone | 702-933-9103
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Fax | 702-933-9104
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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 | A-4112
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License Number State | NV
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