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General NPI Number Information
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NPI Number | 1952890782
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Entity Type | Individual
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Provider Name | TAMERA BRINZA MA, AUDIOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 2102 MAIN ST
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City | ANDERSON
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State | IN
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Zip | 46016-4369
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Country | US
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Telephone | 765-643-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 8121 E 106TH ST APT 10204
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City | FISHERS
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State | IN
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Zip | 46038-3135
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Country | US
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Telephone | 317-507-6252
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23001563A
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License Number State | IN
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