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General NPI Number Information
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NPI Number | 1770077174
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Entity Type | Individual
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Provider Name | HAYDEN GRACE KOUKIOS AU.D
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Gender | Female
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 9000 W. WISCONSIN AVENUE STE B340
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City | MILWAUKEE
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State | WI
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Zip | 53226-5600
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Country | US
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Telephone | 414-266-2934
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Fax | 414-266-6189
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Provider Business Mailing Address
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Address Line | 9000 W. WISCONSIN AVENUE MS 958
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 414-266-7615
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Fax | 414-266-6238
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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 | 665-156
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License Number State | WI
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