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General NPI Number Information
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NPI Number | 1548402704
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Entity Type | Organization
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Legal Business Name | MILLENNIUM HEARING SERVICES INC.
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 4725 HOEN AVE SUITE B
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City | SANTA ROSA
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State | CA
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Zip | 95405-7862
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Country | US
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Telephone | 707-542-1154
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Fax | 707-542-4818
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Provider Business Mailing Address
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Address Line | 4725 HOEN AVE SUITE B
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City | SANTA ROSA
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State | CA
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Zip | 95405-7862
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Country | US
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Telephone | 707-542-1154
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Fax | 707-542-4818
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY, PRESIDENT
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Name | DR. MARINA MARIE MULVEY
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Credential | AUD
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Telephone | 707-542-1154
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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 | AU1683
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License Number State | CA
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