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General NPI Number Information
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NPI Number | 1639438708
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Entity Type | Organization
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Legal Business Name | HANOVER AUDIOLOGY PLLC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 7484 LEE DAVIS RD SUITE 10
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-3678
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Country | US
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Telephone | 804-789-1764
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Fax | 804-789-1762
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Provider Business Mailing Address
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Address Line | 7484 LEE DAVIS RD SUITE 10
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-3678
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Country | US
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Telephone | 804-789-1764
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Fax | 804-789-1762
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY/OWNER
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Name | DR. JANET TINSLEY HILES BRETT
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Credential | AUD
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Telephone | 804-789-1754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 2101001224
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2201222629
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License Number State | VA
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