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General NPI Number Information
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NPI Number | 1477742054
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Entity Type | Individual
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Provider Name | SUZANNE GUNDERSON CRISAFULLI M.A.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 1521 N COOPER ST STE 210
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City | ARLINGTON
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State | TX
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Zip | 76011-5522
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Country | US
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Telephone | 817-983-2550
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Fax | 817-983-2551
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Provider Business Mailing Address
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Address Line | 2908 SAINT VINCENT DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7654
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Country | US
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Telephone | 682-518-0021
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Fax |
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 51533
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License Number State | TX
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