| NPI | 1750920674 |
|---|---|
| Former Name | THERESA NICOLE VITALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002872-01) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000059200) |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2023-06-21 |