NPI | 1740598622 |
---|---|
Former Name | ERIN L PROVOST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002312-1) |
Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 002312) |
Enumeration Date | 2010-09-14 |
Last Update Date | 2024-11-14 |