MEDICARE: MOLLY JORDAN HOWLETT AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2201000547	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487624219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY JORDAN HOWLETT AU.D.

Provider Business Mailing Address
First Line	:	4356 BONNEY RD
Second Line	:	BLDG.1, SUITE 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1200
Country	:	US
Telephone Number	:	757-918-6761
Fax Number	:

Provider Business Practice Location Address
First Line	:	4356 BONNEY RD
Second Line	:	BLDG.1, SUITE 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1200
Country	:	US
Telephone Number	:	757-918-6761
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	04/16/2024

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