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General NPI Number Information
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NPI Number | 1619266939
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Entity Type | Individual
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Provider Name | CARA MAKUTA AUD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 34 S MAIN ST
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City | WILKES BARRE
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State | PA
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Zip | 18701
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Country | US
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Telephone | 570-822-6122
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Fax | 570-822-7809
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Provider Business Mailing Address
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Address Line | 34 S MAIN ST SUITE 101
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City | WILKES BARRE
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State | PA
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Zip | 18701-1734
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Country | US
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Telephone | 570-822-6122
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Fax | 570-822-7809
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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 | AT006340
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License Number State | PA
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