| NPI | 1255513818 |
|---|---|
| Former Name | STEPHANIE LEIGH WIXOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA7605) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA7605) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2020-04-13 |